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  • Title: Update on cancer risk and oral contraceptives.
    Author: Engel NS.
    Journal: MCN Am J Matern Child Nurs; 1990; 15(1):37. PubMed ID: 2105427.
    Abstract:
    A North American case control study of 521 women under 45 years of age with breast cancer and 521 matched controls showed that incidence of oral contraceptive (OC) use prior to the birth of their 1st child was almost equal for both groups. It was also the same for those under 25 years of age (both cases and controls). A longitudinal study of 121,964 US nurses (592 of whom developed breast cancer) did not find increased risk for breast cancer among OC users. The age of first OC use was not significant. Another US study did not discover an association between OC use and breast cancer in women who had earlier had benign breast disease. In Scandinavia, a case control study of 422 women with breast cancer and 722 controls revealed a significant association between duration of OC use and breast cancer risk. The risk factor increased 2-fold after 7 years of OC use. A UK case control study of 755 women with breast cancer and 755 matched controls found a significant association between OC use and breast cancer risk. A UK longitudinal study showed a significant positive association between cervical cancer incidence and duration of OC use even when the researchers removed OC users who used barrier methods. OC users were less likely to have ovarian and endometrial cancer, however. Yet OC use was greatly related to death from all genital tract cancers. The discrepancy between the North American and European studies suggests that nurses should screen all women using OCs or wishing to use OCs for cancer risks which include known or suspected breast or reproductive tract cancer and abnormal vaginal bleeding. They must inform OC users of the association between genital infection and cervical cancer. They must advise OC users not in a monogamous relationship to use a barrier method. Estrogen doses in OCs while lower today than 30 years ago, are associated with cancer risk.
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