Risk factors of ovarian cancer: family history, obesity and oral contraceptive use

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.

Download Full-text

Incidence of Venous Thromboembolism in Families with Inherited Thrombophilia

Thrombosis and Haemostasis ◽

10.1055/s-0037-1614442 ◽

1999 ◽

Vol 81 (02) ◽

pp. 198-202 ◽

Cited By ~ 210

Author(s):

Paolo Simioni ◽

Bernd-Jan Sanson ◽

Daniela Tormene ◽

Philip Friederich ◽

Bruno Girolami ◽

...

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Oral Contraceptive ◽

Contraceptive Use ◽

Post Partum ◽

Family Members ◽

Factor V Leiden ◽

Factor V ◽

Relative Risks ◽

Oral Contraceptive Use

SummaryThe risk of spontaneous or risk-period related venous thromboembolism in family members of symptomatic carriers of antithrombin (AT), protein C (PC) or protein S (PS) defects, as well as of the Factor V Leiden mutation is still undefined. We performed a retrospective cohort study in family members (n = 793) of unselected patients with a documented venous thromboembolism and one of these deficiencies to make an estimate of this risk. The annual incidences of total and spontaneous venous thromboembolic events in carriers of AT, PC or PS defects (n = 181) were 1.01% and 0.40%, respectively, as compared to 0.10% and 0.04% in non-carriers, respectively (relative risks both 10.6). In carriers of Factor V Leiden (n = 224), the annual incidences of total and spontaneous venous thromboembolism were 0.28% and 0.11%, respectively, as compared to 0.09% and 0.04% in non-carriers, respectively (relative risks 2.8 and 2.5). Additional risk factors (immobilisation, surgery and trauma; oral contraceptive use; and pregnancy/ post-partum) increased the risk of thrombosis in carriers of AT, PC and PS defects as compared to non-carriers (relative risks 8.3, 6.4 and 8.2, respectively). Oral contraceptive use and pregnancy/ post-partum period increased the risk of thrombosis in carriers of Factor V Leiden to 3.3-fold and 4.2-fold, respectively, whereas other risk factors had only a minor effect.These data lend some support to the practice of screening family members of symptomatic carriers of a AT, PC and PS deficiency. For family members of symptomatic carriers of Factor V Leiden, screening does not seem to be justified except for women in fertile age.

Download Full-text