Hormonal contraception and risk of cancer

Cibula, David; Gompel, Anne; Mueck, Alfred O.; Vecchia, Carlo La; Hannaford, Philip Christopher; Skouby, Sven O.; Zikán, Michal; Dušek, Ladislav

doi:10.1093/humupd/dmq022

Cited by 211 publications

(139 citation statements)

References 178 publications

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“…Other epidemiologic characteristics do not differ significantly between BOT and ovarian carcinomas, and epidemiological studies have also confirmed similar reproductive risk factors in BOTs as in ovarian cancers, except for higher frequency of infertility [18,19]. Rather than a single hypothesis, an overlap in mechanisms involved in each hypothesis may more likely explain the reproductive risk factors in full.…”

Section: Epidemiologymentioning

confidence: 98%

Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors

et al. 2012

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After completing this course, the reader will be able to:1. Compare the epidemiologic and reproductive risk factors in BOTs with those in ovarian cancers and describe the molecular background of development of BOTs.2. Use the pathological terminology with either original grouping of borderline category or new subclassification of BOTs and assess the major predictor of recurrence and survival.3. Determine an appropriate diagnostic algorithm for patients with symptoms suggesting malignant ovarian tumors that will identify borderline ovarian tumors when present.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTBorderline ovarian tumors represent a heterogeneous group of noninvasive tumors of uncertain malignant potential with characteristic histology. They occur in younger women, are present at an early stage, and have a favorable prognosis, but symptomatic recurrence and death may be found as long as 20 years after therapy in some patients. The molecular changes in borderline ovarian tumors indicate linkage of this disease to type I ovarian tumors (lowgrade ovarian carcinomas). The pathological stage of disease and subclassification of extraovarian disease into invasive and noninvasive implants, together with the presence of postoperative macroscopic residual disease, appear to be the major predictor of recurrence and survival. However, it should be emphasized that the most important negative prognostic factor for recurrence is just the use of conservative surgery, but without any impact on patient survival because most recurrent diseases are of the borderline type-easily curable and with an excellent prognosis. Borderline tumors are difficult masses to correctly preoperatively diagnose using imaging methods because their macroscopic features may overlap with invasive and benign ovarian tumors. Over the past several decades, surgical therapy has shifted from a radical approach to more conservative treatment; however, oncologic safety must always be balanced. Follow-up is essential using routine ultrasound imaging, with special attention paid to the remaining ovary in conservatively treated patients. Current literature on this topic leads to a number of controversies that will be discussed thoroughly in this article, with the aim to provide recommendations for the clinical management of these patients. The Oncologist

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Section: Epidemiologymentioning

confidence: 98%

Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors

et al. 2012

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“…OCPs have protective effects due to the efficacy of progesteronic agents against endometrial cancer. At least one year of OCP use is associated with a 50% decline in the risk of cancer; this protection is maximized by 3 years of OCP use (the effects persist for 20 -30 years) (23). The protective properties of OCPs affect 3 types of endometrial cancers, ie, endometrioid carcinoma, clear cell endometrial cancer, and papillary serous endometrial cancer (24,25).…”

Section: Resultsmentioning

confidence: 99%

A Review of Recent Findings for Obstetricians about Combined Oral Contraceptive Pills

Aminimoghaddam

2017

J Obstet Gynecol Cancer Res

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Combined oral contraceptive pills (OCPs) contain estrogen (ethinylestradiol) and progesterone (first-generation levonorgestrel and fourthgeneration drospirenone). Progesterone has peripheral effects on the endometrium, fallopian tubes, and cervix and can promote contraception. These pills are used to prevent pain caused by Mittelschmerz syndrome and endometriosis and to treat hyperandrogenism. To prescribe contraceptives, it is adequate to take the patient's medical history and blood pressure. In the absence of risk factors, patients should be followed-up by history-taking, blood pressure measurement, urinalysis, Pap smear test, and examination of breasts, pelvis, and liver. The risk of venous thrombosis in new OCPs is twice higher than that of older generations and usually occurs in the first year of consumption. The only absolute contraindications for the use of new OCPs include chronic and acute cholestatic liver diseases. In fact, use of new OCPs increases the risk of liver adenoma, but not hepatocellular carcinoma. On the other hand, in female patients with genital tract cancers, risk of endometrial and ovarian epithelial cancers decreases following the use of OCPs. However, the risk of cervical adenocarcinoma increases after 5 years of consumption due to cervical eversion and impaired vitamin metabolism. These pills are contraindicated in women above 35 years who smoke more than 15 cigarettes daily or have uncontrolled hypertension, venous thromboembolism, migraine aura, severe hyperglycemia, breast cancer (diagnosed or suspected), or diabetes mellitus associated with cardiovascular diseases.

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“…Research has shown that contraceptives have a significantly protective effect on carcinoma of ovary and corpus uteri. 19,20 In fact, a collaborative reanalysis of individual data from 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies revealed that while women were taking COC pills and in the 10 years after stopping, there was a small increase in the relative risk of breast cancer. 21 There was, however, no significant excess risk of having breast cancer diagnosed ≥10 years after stopping use of COC pills.…”

Section: Discussionmentioning

confidence: 99%