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  • Title: Oral contraceptives and cancer.
    Journal: FDA Drug Bull; 1984 Apr; 14(1):2-3. PubMed ID: 6734989.
    Abstract:
    The Food and Drug Administration (FDA), in agreement with the recommendations of its Fertility and Maternal Health Drugs Advisory Commite, concluded that there appears to be no increased risk of breast cancer in oral contraceptives (OC) users or any subgroup of users, or with any particular type of OC. However, the FDA is concerned that there may be an increased risk of cervical carcinoma among OC users. Since the introduction of OCs, many investigations have been conducted to address their possible relationship to carcinogenesis. Studies have demonstrated that OCs appear to have a protective effect against ovarian and endometrial cancer. The risk for ovarian cancer has been found to be lower among all OC users than among nonusers. The longer a woman used OCs, the lower her risk of ovarian cancer, and the lower risk persisted after OC use had stopped. The protective effect against endometrial cancer was observed only with the combination OCs containing both an estrogen and progestogen. A greater risk of endometrial cancer was reported in women taking sequential pills, which are no longer marketed in the US. An increased risk of breast cancer in longterm use before age 25 of combination type OCs with a "high" progestogen content and an increased risk of cervical carcinoma in OC users compared with IUD users have been reported. In November 1983 the National Institute of Child Health and Human Development convened a meeting to discuss the findings of the breast cancer study. Questions were raised specifically about the use of the delay of menses test as the sole basis for ranking progestogen potency, the accuracy of telephone interviews, and the possibility of age differences in cases and controls. Other studies were also reviewed. The findings of the breast and cervical cancer studies were also presented to FDA's Fertility and Maternal Health Drugs Advisory Committee in February 1984. Although the data from the cervical cancer study may be confounded by sexual activity, smoking, and other variables, the FDA concluded that there may be an increased risk of cervical carcinoma among OC users. Women taking OCs should be monitored carefully with physical examinations and Pap tests, at least yearly. The FDA also recommends that OCs with the lowest effective dose of estrogen be used. For any given estrogen-progesogen combination, it is advisable to use that product which contains the lowest doses of estrogen and progestogen consistent with the needs of the patient.
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