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  • Title: [Oral contraceptives and cancer].
    Author: Ludwig H.
    Journal: Schweiz Rundsch Med Prax; 1989 Nov 14; 78(46):1273-5. PubMed ID: 2814116.
    Abstract:
    Recently some studies have shown an association between the pill and increased risk of breast cancer and cancer of the cervix. Several well- designed prospective studies indicated that there was an increased risk of breast cancer for women without children with menarche before 13 who took the pill for many years. A control case study of 407 breast cancer victims compared 424 controls found that the risk of women who had taken hormonal contraceptives was double, however, the duration of use, age, parity was not considered. Although there has been a slight increase of breast cancer incidence in Switzerland, it could be attributed to better diagnostic measures. The increase or dysplasia and carcinoma of the cervix has been linked to taking the pill for 5 years or more, but making a direct correlation is speculative. Among smokers cervical carcinoma is more frequent even without pill use. The pill has changed sexual habits allowing sexual intercourse at an earlier age with more partners and spreading sexually-transmitted carcinogens (human papilloma virus). Cytological cervix control, treatment of vaginal infections, and use of condoms or other barrier methods could minimize this risk. On the other hand, an analysis of data of 47,000 women observed since 1967 indicated that there were more carcinoma in situ findings and even more invasive cervical carcinomas after using the pill for 10 years or longer. The incidence of carcinoma of the endometrium is lower after longterm use of the pill due to the antiestrogenic effect of the gestagen component. Similarly, after taking a combination preparation for 6 months the incidence of ovarian carcinomas also dropped, especially among nulliparas. Medical advice should include careful explanation of risks and benefits of the pill, cytological examination when the pill os prescribed. The low-dose micropills seem to diminish the risks, but nonhormonal alternatives are also available.
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