01 Oct Combination Oral Contraceptives Associated With Reduced Ovarian Cancer Risk
MedicalResearch.com Interview with:
Dr Lisa Iversen PhD; MSc Epidemiology
Academic Primary Care
Institute of Applied Health Sciences
University of Aberdeen
MedicalResearch.com: What is the background for this study?
Response: Everyday at least 100 million women worldwide use hormonal contraception. Previous research has found a reduced risk of ovarian cancer in women using combined oral contraceptives but this evidence related to older products. It is important for users of contemporary combined oral contraceptives to know whether they are likely to experience the same patterns of reduction in risk of ovarian cancer and whether the benefit is specific to a particular formulation. Users of other hormonal contraceptives such as those with non-oral routes of administration and progestogen-only products should also know whether they have a reduced risk of ovarian cancer.
We investigated the influence of all contemporary hormonal contraceptives on ovarian cancer risk in over 1.8 million women in Denmark aged 15-49 years, over a 20 year period from 1995-2014.
MedicalResearch.com: What are the main findings?
Response: Compared to never users, current or recent users of hormonal contraceptives and former users had a reduced risk of ovarian cancer. The reduced risk became stronger the longer time period hormonal contraceptives were used and the protection remained several years after stopping. We found most of the hormonal contraceptive use was of combined oral contraceptives. There was little evidence of important differences between products containing different progestogens. The reduced risk of ovarian cancer for combined products was seen for most ovarian cancer types. There was no firm evidence to suggest any protective effect among women who had used progestogen-only products but few women exclusively used these contraceptives so their limited data might not be powerful enough. We estimate that hormonal contraception prevented 21% of ovarian cancers in our study
MedicalResearch.com: What should readers take away from your report?
Response: Our findings are reassuring to women of reproductive age, contemporary combined oral contraceptives (which generally contain lower doses of oestrogen and newer progestogens) are still associated with a reduced risk of ovarian cancer.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: It is still to be established how long the protective effects associated with contemporary combined oral contraceptives persist. We were unable to investigate this as our study examined contemporary products and did not include older women.
MedicalResearch.com: Is there anything else you would like to add?
Response: Although our observational study is unable to draw conclusions about cause and effect, it is noteworthy that our findings are consistent with studies of older products.
All authors have completed the ICMJE uniform disclosure form and declare Professor Lidegaard reports grants from Novo Nordisk Foundation, during the conduct of the study; and has been an expert witness in two legal cases in the US on hormonal contraception and venous thrombosis for the plaintiff in 2011 and 2012. Dr Mørch reports grants from Novo Nordisk Foundation, during the conduct of the study. Professor Hannaford and Drs Iversen, Fielding and Skovlund have nothing to disclose.
Association between contemporary hormonal contraception and ovarian cancer in women of reproductive age in Denmark: prospective, nationwide cohort study
BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3609 (Published 26 September 2018)Cite this as: BMJ 2018;362:k3609
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