Abstract
Background: Approximately 70–75 % of women between 18 and 50 years of age in Germany use one of many different contraceptive methods and more than half of them use combined hormonal oral contraceptives. These women demand two things from contraception: high contraceptive safety and low side effects. Thromboembolic and cardiovascular risks were recently under broad discussion in the media but the question whether hormonal contraceptives modify the risk for cancer is an important issue for many women and their doctors as well. This applies especially to women with a genetic disposition for malignant diseases.
Aim: How is cancer risk modified in women with current or recent hormonal contraceptive use? The dependency of risk on duration of use, intervals between intake and use in particularly hormone-sensitive phases of life (such as puberty) are described.
Material and methods: State of the art information is presented and discussed in view of the results of current meta-analyses, as well as national and international guidelines.
Results: Current meta-analyses showed a significant risk reduction for endometrial and ovarian cancer in combined oral contraceptive users with increased risk reduction following increased duration of use. No significant increase for risk of breast cancer was reported. No uniform data on risk modification for cancer of the cervix uteri and colon cancer in current users of hormonal contraceptives are available. This applies not only for the general population but also for carriers of breast cancer (BRCA) mutations.
Conclusion: For women without a hormone-dependent tumor or disease in the medical history, there is no contraindication for hormonal contraception due to elevated cancer risk. However, the data are not sufficient to justify their use exclusively for chemoprevention, such as for ovarian cancer in high-risk patients.
Translated title of the contribution | Pills and cancer risk: Contraindication versus chemoprevention |
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Original language | German |
Pages (from-to) | 138-143 |
Number of pages | 6 |
Journal | Gynakologische Endokrinologie |
Volume | 12 |
Issue number | 3 |
DOIs | |
State | Published - Sep 2014 |