Highlights
- •13% of all ovarian cancers in Ontario occur in the 0.7% of women above 5% risk.
- •BRCA1/2 mutations account for 89% of ovarian cancer patients at high risk.
- •Achieving maximum impact will require population-based genetic testing of BRCA1/2.
Abstract
Objective
It is important to identify women in the population who have a high risk of ovarian
cancer and who might benefit from prophylactic bilateral salpingo-oophorectomy. The
probability that a woman will develop ovarian cancer depends on her current age, her
reproductive history and her genetic status.
Methods
We simulated the distribution of ovarian cancer risk for the 2011 Ontario female population.
We generated (at random) individual risks of ovarian cancer to age 80 for 6,301,340
women, based on the published risk factors, mutation frequencies and population age-specific
incidence rates (SEER database). Risk factors included parity, breastfeeding, oral
contraceptives, tubal ligation and family history. Genetic factors included 11 single
nucleotide polymorphisms (SNPs) and BRCA1/2 mutations.
Results
Of the 6,301,340 women simulated as the general population of Ontario, the (complete)
model predicts that 65,805 women (1.0%) will develop ovarian cancer by age 80. There
were 46,069 women (0.7%) with a risk of ovarian cancer above 5%. BRCA1/2 mutation
carriers accounted for 67.4% of the women at greater than 5% risk (31,028 women).
Among ovarian cancer patients at greater than 5% risk, a BRCA1/2 mutation was present
in 89.2%. In contrast, SNPs contribute to a very small proportion of the ovarian cancer
patients who were at greater than 5% risk.
Conclusions
Approximately 12.9% of all ovarian cancers in Ontario occur in the 0.7% of women in
the general population who have a lifetime ovarian cancer risk in excess of 5%, the
majority of whom carry a mutation in BRCA1 or BRCA2.
Keywords
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Article info
Publication history
Published online: September 02, 2015
Accepted:
August 25,
2015
Received in revised form:
August 24,
2015
Received:
June 9,
2015
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
