D. Lazaris

1st Department of Obstetrics & Gynecology, University of


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



  1. 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.

  2. 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

  3. 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.

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