Cancer
D. Lazaris
1st Department of Obstetrics & Gynecology, University of Athens
The impact of combined oral contraceptives (COCs) on carcinogenesis is a major issue of concern in clinical practice. So, extensive research has been conducted in order to investigate this relationship.
Recent data from many epidemiological studies on the impact of COCs use upon carcinogenesis of the female genital tract are presented and commented.
Conclusion
Evidently COCs ever use, substantially protects from the risk of ovarian carcinoma. The above mentioned protection depends on the duration of COCs use, persists for many years after ceasing of the treatment and it is estrogen dose -independent.
There is, also strong evidence of a protective effect of COCs from endometrial cancer. This effect seems to be mediated by the progestin component of the pills, it is positively related to the duration of use (more than 3-5 years) and the protection persists for at least 20 years after discontinuation
On the contrary there was observed a positive association between COCs current use and increased risk of neoplasia of the uterine cervix in most studies but it should be referred that the COCs users had lower use of barrier methods (protecting from HPV contamination, which is the well known causative factor of cervical neoplasia) compared to the control group.
The above mentioned results are discussed, possible explanations on them are given and the relationship between COCs and carcinogenesis on the breasts and other sites of the female body are presented and commented too.