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
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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.
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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
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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.