The Pharmaceutical Journal
Vol 268 No 7191 p419-425
30 March 2002

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The Lancet (www.thelancet.com)

Risk of cervical cancer increased by long-term oral contraception

Long-term use of oral contraceptives increases the risk of cervical carcinoma, a study confirms (Lancet 2002;359:1085).

Researchers from the International Agency for Research on Cancer (IARC) pooled data from 10 studies of women with cervical carcinoma who were positive for human papillomavirus (HPV).

Use of oral contraceptives for five years or longer increased risk of cervical cancer three-fold in HPV-positive women. The researchers suggest that oral contraceptives might promote a step in the process of HPV-related cervical carcinogenesis.

A link between increased risk of cervical cancer and oral contraception was previously known but this study indicates it is an independent factor rather than a lifestyle factor increasing HPV infection rate.

A second study by IARC researchers found a direct association between number of full-term pregnancies and risk of cervical cancer in HPV-positive women (ibid, p1093).

In an accompanying editorial (ibid, p1080), Dr David Skegg, University of Otago, New Zealand, comments that the results suggest that oral contraception and a high number of pregnancies "act not by enhancing the acquisition or persistence of HPV infection, but rather by promoting progression to cervical intraepithelial neoplasia (CIN) and invasive cancer."

A spokeswoman for the fpa (formerly the Family Planning Association) said: "The benefits of using oral contraception outweigh the risks for the vast majority of women. The pill ... reduces risk of both cancer of the ovaries and the womb."