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#Grand Rounds

Long-Term Oral Contraceptive Use and Cancer Risk

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BACKGROUND AND PURPOSE:

  • Karlsson et al. (Cancer Research, 2020) assessed the time-dependent effects of long-term oral contraceptive use on cancer risk

METHODS:

  • Observational cohort study (UK Biobank)
  • Participants
    • Women born between 1939 and 1970
  • Exposure
    • Ever use of oral contraceptives
  • Study design
    • Information on cancer diagnoses were collected from self-reported data and from national registers until March 2019

RESULTS:

  • 256,661 women
  • Odds of cancer were lower among ever users of oral contraceptives
    • Ovarian cancer: OR 0.72 (95% CI, 0.65 to 0.81)
    • Endometrial cancer: OR 0.68 (95% CI, 0.62 to 0.75)
    • Association stronger with longer use
    • Protective association for above cancers remained significant up to 35 years after last use of oral contraceptives (P<0.001)
  • Increased breast cancer risk was seen when follow-up was limited to 55 years of age, but not for the full lifespan
    •  Limited follow-up: OR 1.10 (95% CI, 1.03 to 1.17)
  • The researchers only found a higher breast cancer risk in former users immediately (≤2 years) after discontinuing oral contraceptive use
    • Hazard ratio 1.55 (95% CI, 1.06 to 2.28)

CONCLUSION:

  • The use of oral contraceptives reduces the risk of ovarian and endometrial cancer
  • Oral contraceptives effect on the risk of breast cancer over a lifetime is limited
  • The authors state that this study data

…reflect a shorter latency period for breast cancer in oral contraceptive users, rather than a larger lifetime risk, compared to never users

Learn More – Primary Sources:

Time-dependent effects of oral contraceptive use on breast, ovarian and endometrial cancers

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Related ObG Topics:

Do Contraceptives Decrease Risk for All Ovarian Cancers?
Current Hormonal Contraception Methods and Breast Cancer Risk: Prospective Cohort Data
Is there a Link Between Oral Contraception Use and Cancer Risk?
Do Lifestyle Characteristics Modify the Association between Duration of Oral Contraception Use and Related Cancers?

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