Hormonal and Reproductive Factors Influence Uterine Cancer Risk in Lynch Syndrome

Aung Ko Win, MBBS MPH PhD Research Fellow NHMRC Early Career Clinical Research Fellow Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health The University of Melbourne VIC 3010 AustraliaMedicalResearch.com Interview with:
Aung Ko Win, MBBS MPH PhD

Research Fellow
NHMRC Early Career Clinical Research Fellow
Centre for Epidemiology and Biostatistics
Melbourne School of Population and Global Health
The University of Melbourne VIC 3010
Australia

Medical Research: What is the background for this study? What are the main findings?

Response: About 2-5% of uterine cancer are associated with an underlying genetic condition mainly Lynch syndrome. Lynch syndrome is caused by a mutation in one of the mismatch repair genes. At least 1 in 1000 people in the population have a mutation that causes Lynch syndrome and these people have a very high risk of cancers mainly bowel and uterine cancers. One in three women with a mutation in one of the mismatch repair genes are likely to develop a uterine cancer in their lifetime. The only way to reduce the risk of uterine cancer for these women is to remove the uterus. There is no current recommendation for screening method to detect uterine cancer early. Almost nothing is known about if and how lifestyle factors and hormonal factors can modify their risk of uterine cancer.

By studying 1128 women with a mutation that causes Lynch syndrome who were recruited from Australia, New Zealand, Canada and the USA, we found that later age at first menstrual cycle, having one or more live births, and using hormonal contraceptive use for one year or longer were associated with a lower risk of uterine cancer.

Medical Research: What should clinicians and patients take away from your report?

Response: For women with a Lynch syndrome mutation, some reproductive and hormonal factors are associated with a lower risk of uterine cancer. The directions and strengths of associations are similar to those for women from the general population. If replicated, women with a Lynch syndrome mutation may be counseled like the general population in regard to hormonal influences on uterine cancer risk.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: It is important to conduct further research on the role of lifestyle and hormonal factors in the development of uterine cancer in women with a Lynch syndrome mutation. Identifying modifiers of cancer risks for people with a Lynch syndrome mutation is important for them to reduce their cancer risks.

Citation:

Seyedeh Ghazaleh Dashti, Rowena Chau, Driss Ait Ouakrim, Daniel D. Buchanan, Mark Clendenning, Joanne P. Young, Ingrid M. Winship, Julie Arnold, Dennis J. Ahnen, Robert W. Haile, Graham Casey, Steven Gallinger, Stephen N. Thibodeau, Noralane M. Lindor, Loïc Le Marchand, Polly A. Newcomb, John D. Potter, John A. Baron, John L. Hopper, Mark A. Jenkins, Aung Ko Win. Female Hormonal Factors and the Risk of Endometrial Cancer in Lynch Syndrome. JAMA, 2015; 314 (1): 61 DOI: 10.1001/jama.2015.6789

Aung Ko Win, MBBS MPH PhD, Research Fellow, & NHMRC Early Career Clinical Research Fellow (2015). Hormonal and Reproductive Factors Influence Uterine Cancer Risk in Lynch Syndrome