(2002; 91 pages)
Oral contraceptives and risk of cervical cancer
The Department of Health in the United Kingdom has issued an urgent communication informing health professionals of a recent study which, although not conclusive, strengthens the evidence that oral contraceptives may contribute to the development of cervical cancer in women with high risk type human papilloma (HPV) (1).
The study reports an association between increasing risk of cervical cancer and duration of use of oral contraceptives (threefold increase in risk following 5-9 years of oral contraceptive use versus a fourfold increase after 10 or more years) in women with HPV. HPV is a sexually transmitted infection. There are more than 80 HPV viruses, but only a few are associated with an increased risk of cervical cancer. On current evidence it is difficult to state whether it is the use of oral contraceptives, sexual activity, the type of HPV or the duration of HPV infection which is /are the main precipitating factor(s) for cervical cancer.
Furthermore, the original studies were carried out in women from developing countries with no adequate cervical screening programme. While cervical screening is not perfect, between 80% and 90% of cervical abnormalities can be detected and treated in women who attend regular screening pro-grammes. The communication therefore advises that all sexually active women, especially those on long-term oral contraceptives, be encouraged to have regular cervical smears. The benefits of using OCs outweigh the risks in the vast majority of women who use them.
1. Urgent Communication from Chief Medical Officer, 27 March 2002. http://www.mca.gov.uk
2. Lancet, 359: 1085-1101 (2002).