Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23 257 women with ovarian cancer and 87 303 controls

2009 ◽  
Vol 2009 ◽  
pp. 161-165
Author(s):  
L.P. Shulman
2010 ◽  
Vol 63 (9-10) ◽  
pp. 657-661 ◽  
Author(s):  
Milena Veljkovic ◽  
Slavimir Veljkovic

Introduction. Oral contraceptives, mainly combined monophasic pills, are widely used by young women who expect their physicians to prescribe them safe drugs which will not harm their health and which will simplify their life. Numerous epidemiologic studies have been performed to determine the relation between oral contraceptive use and the development of neoplasms. Breast cancer. An increased incidence of breast cancer has occurred simultaneously with the growing use of oral contraceptives. The possibility of a link between the oral contraceptive use and breast cancer has led to intensive research, but studies have provided inconsistent results causing confusion among clinicians. It was noticed that the risk of breast cancer was slightly elevated in current and recent young oral contraceptives users. That finding could be influenced by a detection bias or could be due to the biologic effect of the pills. The absolute number of additional breast cancer cases will be very small because of low baseline incidence of the disease in young women. Oral contraceptives probably promote growth of the already existing cancer, they are probably promoters not initiators of breast cancer. The available data do not provide a conclusive answer that is need. Cervical cancer. Numerous factors may influence the development of cervical cancer. The evidence suggests that current and recent oral contraceptive users have an increased risk of cervical cancer which decline after discontinuation of the application of medication. Oral contraceptives might increase the biological vulnerability of the cervix. Cervical cancer develops slowly over a long time period and can be effectively prevented by periodic cervical screening. Fortunately, oral contraceptives do not mask abnormal cervical citology. Conclusions regarding invasive cervical cancer and oral contraceptive use are not definitive but if there is any increased risk, it is low. Endometrial cancer. In oral contraceptive users the endometrium is almost under the influence of progestin component which suppresses endometrial mitotic activity and its proliferation. Most epidemiologic studies show that oral contraceptives reduce the risk of endometrial cancer and that this protective effect exists many years after the discontinuation of medication. Ovarian cancer. It has been long known that the oral contraceptive use causes protective an ovulation and reduces the risk of ovarian cancer. This powerful reduction is the best demonstrated major benefit of oral contraception. This protection is especially observed in nulliparous and seems to persist for many years after the discontinuation of medication.


2016 ◽  
Vol 38 (2) ◽  
pp. 589-597 ◽  
Author(s):  
Yiyang Li ◽  
Yang Li ◽  
Jialing Zhang ◽  
Changjun Zheng ◽  
He Zhu ◽  
...  

Background/Aims: Insulin-like growth factor-1 (IGF-1) has an important role in cells' proliferation, differentiation and apoptosis, and it may be involved in carcinogenesis. Several epidemiological studies assessed the association between circulating IGF-1 level and ovarian cancer risk, but there was still no conclusive finding. Methods: A meta-analysis of published studies was performed to assess the association between circulating IGF-1 level and ovarian cancer risk. The summary odds ratio (OR) with 95% confidence interval (95%CI) was calculated through meta-analysis to evaluate the strength of the association. Results: Five eligible studies were included into the meta-analysis, which involved a total of 2,028 cases of ovarian cancer and 4,625 controls. Meta-analysis of total 5 studies showed that high circulating IGF-1 level was correlated with decreased risk of ovarian cancer (OR = 0.84, 95%CI 0.74-0.97, P = 0.013). After adjusting for heterogeneity, high circulating IGF-1 level was still correlated with decreased risk of ovarian cancer (OR = 0.83, 95%CI 0.72-0.95, P = 0.007). Subgroup analysis by age showed that circulating IGF-1 level was not correlated with ovarian cancer risk in women both less than 55 years and more than 55 years. However, after adjusting for heterogeneity, high circulating IGF-1 level was correlated with decreased ovarian cancer risk in women less than 55 years (OR = 0.82, 95%CI 0.72-0.94, P = 0.004). Conclusion: Our meta-analysis suggests that high circulating IGF-1 level may be correlated with decreased ovarian cancer risk, especially in women less than 55 years. More studies are needed to further assess the association between circulating IGF-1 level and ovarian cancer risk in the future.


Cephalalgia ◽  
2000 ◽  
Vol 20 (3) ◽  
pp. 183-189 ◽  
Author(s):  
M-G Bousser ◽  
S J Kittner

Since 1962, more than 25 studies have been devoted to the relationship between oral contraceptives and stroke. They are all case-control or cohort epidemiological studies and thus contain the difficulties and biases that are inherent in these types of studies. The following conclusions can be drawn from these studies: High oestrogen content (≥ 50 μg) increases the risk of stroke, all stroke subtypes, and stroke death. Low oestrogen content (< 50 μg) carries a very low or no risk of stroke. There are no data on progestogen only oral contraceptives. Stroke risk is greatly increased if associated risk factors are present, in particular hypertension, cigarette smoking and migraine. Oral contraceptives, even at low doses, significantly increase the risk of cerebral venous thrombosis, which is further enhanced if congenital thrombophilia is present. The attributable risk of stroke in young women using oral contraceptives is about 1 per 200 000 woman-years. The contraceptive and non-contraceptive benefits of low dose oral contraceptives vastly outweigh their risks provided that other risk factors are absent or well controlled.


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