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  • Title: [Possible link between long-term oral contraceptive use and cervical cancer].
    Journal: Perspect Int Planif Fam; 1987; (Spec No):40-1. PubMed ID: 12269054.
    Abstract:
    A new study of the relationship between use of oral contraceptives (OCs) and development of invasive cervical cancer found an increased risk of this cancer with longer durations of use and higher doses of estrogens. Pill users under 35, who had never used barrier methods, and who had histories of vaginal infections or abnormal Pap tests appeared more likely to develop cervical cancer. 658 women were diagnosed with invasive cervical cancer between April 1982-January 1984 in hospitals in 5 cities that participate in a cancer data gathering system. 479 of the women became cases in the study and were interviewed along with 789 controls matched for age and ethnic background. Controls were selected by random telephone calls to the same telephone exchanges as the cases. Cases averaged 47 years and controls 44 years of age. The data were standardized for age and ethnic background. 44% of cases and 51% of controls had ever used OCs. The risk of developing cervical cancer among women who ever used OCs was .8 in relation to that of women who never used OCs. Subsequent analysis however showed that women who had not had a Pap test in the 10 years prior to diagnosis had 5-6 times greater risk of developing cervical cancer. These women were much less likely to have used pills than were women with more recent Pap tests. When the data were adjusted to take into account the interval since the last Pap test, number of sexual partners, age at first intercourse, educational level, and history of nonspecific genital infections, the ever users of OCs had a risk of 1.5 in relation to nonusers. The relative risk was 1.3 for women using OCs for 5 years or less and 1.8 for those using it for 10 years or more. Women using the pill within 1 year of diagnosis had a relative risk of 2.0 compared to 1.4 for those discontinuing it at an earlier date. The risk did not vary by age at first use of OCs or number of years since first use. Among pill users, the relative risk was 1.7 for women under 35, 1.8 for those never using barrier methods, 2.6 for those with a history of abnormal Pap smears, and 2.1 for those with a history nonspecific genital infections. Relative risk among pill users did not vary by age at first intercourse, number of sexual partners, or number of years of smoking. 87% of cases had squamous cell tumors and 13% had adenocarcinoma or adenosquamous carcinoma. Women using pills with a high estrogen content for 5 years or more had a relative risk of 2.1 compared to nonusers. The researchers believe the findings are a cause for concern, especially since they agree with results of 2 other recent studies.
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