Combination Oral Contraceptives Associated With Reduced Ovarian Cancer Risk

MedicalResearch.com Interview with:

Dr Lisa Iversen PhD; MSc Epidemiology Research Fellow Academic Primary Care Institute of Applied Health Sciences University of Aberdeen

Dr. Iversen

Dr Lisa Iversen PhD; MSc Epidemiology
Research Fellow
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.

Citation:

Association between contemporary hormonal contraception and ovarian cancer in women of reproductive age in Denmark: prospective, nationwide cohort study

BMJ 2018362 doi: https://doi.org/10.1136/bmj.k3609 (Published 26 September 2018)Cite this as: BMJ 2018;362:k3609

Oct 1, 2018 @ 2:44 pm 

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About 20% Increased Risk of Breast Cancer in Women On Oral Contraceptives

MedicalResearch.com Interview with:
“Birth control pills” by lookcatalog is licensed under CC BY 2.0Lina Mørch PhD, MSc

Senior Researcher
Rigshospitalet

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There was a lack of evidence on contemporary hormonal contraception and risk of breast cancer. In particular the knowledge of risk with newer progestins was sparse.

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Should Teenagers Be Able To Get Oral Contraceptives Over The Counter?

MedicalResearch.com Interview with:

Krishna K. Upadhya, M.D., M.P.H. Division of General Pediatrics & Adolescent Medicine Department of Pediatrics Johns Hopkins University School of Medicine Baltimore, MD 21287

Dr. Upadhya

Krishna K. Upadhya, M.D., M.P.H.
Division of General Pediatrics & Adolescent Medicine
Department of Pediatrics
Johns Hopkins University School of Medicine
Baltimore, MD 21287

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our study reviewed medical literature to examine the question of whether minor teens should be treated differently from older women with regard to a future over the counter oral contraceptive product.  Our analysis found that oral contraceptive pills are safe and effective for teens and there is no scientific rationale to restrict access to a future oral contraceptive pill based on age.

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Vitamin D Levels Fall When Estrogen-Containing Birth Control Pills Stopped

MedicalResearch.com Interview with:

Quaker Harmon M.D., Ph.D. Epidemiology Branch National Institute of Environmental Health Sciences Research Triangle Park, NC 27709

Dr. Quaker Harmon

Quaker Harmon M.D., Ph.D.
Epidemiology Branch
National Institute of Environmental Health Sciences
Research Triangle Park, NC 27709

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Vitamin D is important for bone health. In the United States many women are vitamin D deficient. Vitamin D does not naturally occur in many foods, however some foods are fortified with vitamin D. Supplements and sunshine are the most reliable sources of vitamin D.
Previous studies suggested that women using birth control pills containing estrogen had higher levels of vitamin D. These studies were generally small and were not always able to examine important factors such as time spent outside. We were interested in examining the association between hormonal contraception and vitamin D levels in a larger group of women.

We found that women who use estrogen-containing contraception had a 20% increase in their vitamin D levels. This increase was not due to time spent outside or behaviors related to choice of contraception. The magnitude of increase for hormonal contraception was smaller than for regular use of a supplement containing vitamin D.

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Study Finds No Increased Risk of Birth Defects With Birth Control Pill Exposure

Brittany M. Charlton, ScD Instructor Boston Children's Hospital and Harvard Medical School Researcher, Harvard Chan School Department of Epidemiology Boston, MA 02115

Dr. Charlton

MedicalResearch.com Interview with:
Brittany M. Charlton, ScD
Instructor
Boston Children’s Hospital and Harvard Medical School
Researcher, Harvard Chan School Department of Epidemiology
Boston, MA 02115  

Medical Research: What is the background for this study? What are the main findings?

Dr. Charlton: Even though oral contraceptives can be over 99% effective with perfect use, almost 10% of women become pregnant within their first year of use. Many more women will stop using oral contraceptives when planning a pregnancy and conceive within just a few months. In both of those examples, a woman may inadvertently expose her offspring during pregnancy to exogenous sex hormones. We conducted a nationwide cohort study in Denmark in order to investigate whether oral contraceptive use shortly before or during pregnancy was associated with an increased risk of major birth defects in the offspring. Our main finding was that there was no increased risk of having a birth defect associated with oral contraceptive exposure. These results were also consistent when we broke down the birth defects into different subgroups, like limb defects.

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