1. ¹Department of Pathology, The Norwegian Radium Hospital, Oslo N-0310, Norway
2. ²Department of Tumour Biology, The Norwegian Radium Hospital, Oslo N-0310, Norway
3. ³Janus serum bank, Institute of Clinical Biochemistry/Department of Clinical Chemistry, Rikshospitalet University Hospital, Oslo, Norway
4. ⁴The Cancer Registry of Norway, Montebello, Oslo N-0310 Norway
5. ⁵Central Laboratory, The Norwegian Radium Hospital, Oslo N-0310, Norway
6. ⁶Department of Gynaecologic Oncology, The Norwegian Radium Hospital, Oslo N-0310, Norway

Correspondence: Dr T Bjørge, E-mail: tone.bjorge@oslo.online.no

Received 24 May 2004; Revised 24 August 2004; Accepted 27 August 2004; Published online 12 October 2004.

Abstract

The aims of the present study were to find the frequency of the most common BRCA1 mutations in women with ovarian tumours identified from a population-based cancer registry and in the general population, to estimate the relative risk of ovarian tumours among the mutation carriers, and to explore the value of using CA125 as a prediagnostic test. The study was designed as a nested case–control study within a cohort mainly consisting of participants in population-based health examinations. The data files of The Cancer Registry of Norway and the Janus serum bank were linked to identify cases with ovarian cancer and borderline tumours. Hereditary BRCA1 mutations were determined using archived serum samples and capillary electrophoresis. Altogether 478 ovarian cancer patients and 190 patients with borderline tumours were identified, and 1421 and 568 matching controls were selected. Odds ratios (OR) of developing ovarian cancer and borderline tumours in the presence of BRCA1 mutations and CA125 level were derived from conditional logistic regression models. Among the 478 ovarian cancer patients, 19 BRCA1 mutations were identified (1675delA, 1135insA, 816delGT and 3347delAG), none among the patients with borderline tumours. Only two of the 1989 controls were BRCA1 mutation carriers (0.10%). The risk of ovarian cancer among the mutation carriers was strongly elevated (OR=29, 95% CI=6.6–120). CA125 was a marker for ovarian cancer, but the sensitivity was low. This study showed that BRCA1 mutation carriers have a very high risk of ovarian cancer. However, since the prevalence of BRCA1 mutations in the Norwegian population was low, the proportion of ovarian cancers due to BRCA1 mutations seemed to be low, about 4%. The sensitivity of using CA125 only as a screening test for ovarian cancer was low.