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Review
. 2018 Nov;85(4):412-452.
doi: 10.1177/0024363918811637. Epub 2019 Jan 3.

Association of Combined Estrogen-Progestogen and Progestogen-Only Contraceptives with the Development of Cancer

William V Williams  1   2 , Louise A Mitchell  3 , S Kathleen Carlson  4 , Kathleen M Raviele  5
Affiliations
Review

Association of Combined Estrogen-Progestogen and Progestogen-Only Contraceptives with the Development of Cancer

William V Williams et al. Linacre Q. 2018 Nov.

Abstract

Combined estrogen-progestogen contraceptives (oral contraceptives or OCs) and progestogen-only contraceptives (POCs) are synthetic steroids that bind to steroid hormone receptors, which are widespread throughout the body. They have a profound effect on cellular physiology. Combined OCs have been classified by the International Agency for Research on Cancer (IARC) as Group 1 carcinogens, but their findings have not been updated recently. In order to update the information and better understand the impact that OCs and POCs have on the risk of development of cancers, a comprehensive literature search was undertaken, focusing on more recently published papers. In agreement with the IARC, the recent literature confirms an increased risk of breast cancer and cervical cancer with the use of OCs. The recent literature also confirms the IARC conclusion that OCs decrease the risk of ovarian and endometrial cancers. However, there is little support from recent studies for the IARC conclusion that OCs decrease the risk of colorectal cancer or increase the risk of liver cancer. For liver cancer, this may be due to the recent studies having been performed in areas where hepatitis is endemic. In one large observational study, POCs also appear to increase the overall risk of developing cancer. OCs and POCs appear to increase the overall risk of cancer when carefully performed studies with the least intrinsic bias are considered.

Summary: OCs have been classified as cancer-causing agents, especially leading to increases in breast cancer and cervical cancer. A review of the recent scientific literature was performed to see whether this still appears to be the case. The recent literature supports the cancer-causing role of OCs especially for breast cancer and cervical cancer. Studies also indicate that progesterone-only contraceptives (such as implants and vaginal rings) also can cause cancer. This is especially true for breast cancer and cervical cancer.

Keywords: Breast cancer; Cancer; Cervical cancer; Colorectal cancer; Contraception; Contraceptive; Endometrial cancer; Estrogen; Ovarian cancer; Progestogen.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Altman Douglas G. 1991. Practical Statistics for Medical Research. London, UK: Chapman and Hall.
    1. Amadou A., Fabre A., Torres-Mejía G., Ortega-Olvera C., Angeles-Llerenas A., McKenzie F., Biessy C., Hainaut P., Romieu I. 2013. “Hormonal Therapy and Risk of Breast Cancer in Mexican Women.” PLoS One 8:e79695. - PMC - PubMed
    1. An N. 2015. “Oral Contraceptives Use and Liver Cancer Risk: A Dose-response Meta-analysis of Observational Studies.” Medicine (Baltimore) 94:e1619. - PMC - PubMed
    1. Antoniou A. C., Rookus M., Andrieu N., Brohet R., Chang-Claude J., Peock S., Cook M., et al. 2009. “Reproductive and Hormonal Factors, and Ovarian Cancer Risk for BRCA1 and BRCA2 Mutation Carriers: Results from the International BRCA1/2 Carrier Cohort Study.” Cancer Epidemiology, Biomarkers & Prevention 18, no. 2: 601–10. doi: 10.1158/1055-9965.EPI-08-0546. - PubMed
    1. Arab M., Khayamzadeh M., Tehranian A., Tabatabaeefar M., Hosseini M., Anbiaee R., Golfam F., Akbari M. E. 2010. “Incidence Rate of Ovarian Cancer in Iran in Comparison with Developed Countries.” Indian Journal of Cancer 47, no. 3: 322–27. doi: 10.4103/0019-509X.64721. - PubMed

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