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Williams WV, Mitchell LA, Carlson SK, et al. Association of Combined Estrogen-Progestogen and Progestogen-Only Contraceptives with the Development of Cancer. Linacre Q. 2019;85(4):412-452doi: 10.1177/0024363918811637.
Williams, W. V., Mitchell, L. A., Carlson, S. K., & Raviele, K. M. (2018). Association of Combined Estrogen-Progestogen and Progestogen-Only Contraceptives with the Development of Cancer. The Linacre quarterly, 85(4), 412-452. https://doi.org/10.1177/0024363918811637
Williams, William V, et al. "Association of Combined Estrogen-Progestogen and Progestogen-Only Contraceptives with the Development of Cancer." The Linacre quarterly vol. 85,4 (2018): 412-452. doi: https://doi.org/10.1177/0024363918811637
Williams WV, Mitchell LA, Carlson SK, Raviele KM. Association of Combined Estrogen-Progestogen and Progestogen-Only Contraceptives with the Development of Cancer. Linacre Q. 2018 Nov;85(4):412-452. doi: 10.1177/0024363918811637. Epub 2019 Jan 03. PMID: 32431377; PMCID: PMC6322132.
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Linacre Q. 2018 Nov;85(4):412-452. doi: 10.1177/0024363918811637. Epub 2019 Jan 03.

Association of Combined Estrogen-Progestogen and Progestogen-Only Contraceptives with the Development of Cancer.

The Linacre quarterly

William V Williams, Louise A Mitchell, S Kathleen Carlson, Kathleen M Raviele

Affiliations

  1. BriaCell Therapeutics Corporation, West Vancouver, British Columbia, Canada.
  2. University of Pennsylvania, Philadelphia, PA, USA.
  3. Catholic Medical Association, Bala Cynwyd, PA, USA.
  4. University of Virginia, Charlottesville, VA, USA.
  5. Dekalb Medical, Decatur, GA, USA.

PMID: 32431377 PMCID: PMC6322132 DOI: 10.1177/0024363918811637

Abstract

Combined estrogen-progestogen contraceptives (oral contraceptives or OCs) and progestogen-only contraceptives (POCs) are synthetic steroids that bind to steroid hormone receptors, which are widespread throughout the body. They have a profound effect on cellular physiology. Combined OCs have been classified by the International Agency for Research on Cancer (IARC) as Group 1 carcinogens, but their findings have not been updated recently. In order to update the information and better understand the impact that OCs and POCs have on the risk of development of cancers, a comprehensive literature search was undertaken, focusing on more recently published papers. In agreement with the IARC, the recent literature confirms an increased risk of breast cancer and cervical cancer with the use of OCs. The recent literature also confirms the IARC conclusion that OCs decrease the risk of ovarian and endometrial cancers. However, there is little support from recent studies for the IARC conclusion that OCs decrease the risk of colorectal cancer or increase the risk of liver cancer. For liver cancer, this may be due to the recent studies having been performed in areas where hepatitis is endemic. In one large observational study, POCs also appear to increase the overall risk of developing cancer. OCs and POCs appear to increase the overall risk of cancer when carefully performed studies with the least intrinsic bias are considered.

SUMMARY: OCs have been classified as cancer-causing agents, especially leading to increases in breast cancer and cervical cancer. A review of the recent scientific literature was performed to see whether this still appears to be the case. The recent literature supports the cancer-causing role of OCs especially for breast cancer and cervical cancer. Studies also indicate that progesterone-only contraceptives (such as implants and vaginal rings) also can cause cancer. This is especially true for breast cancer and cervical cancer.

© Catholic Medical Association 2018.

Keywords: Breast cancer; Cancer; Cervical cancer; Colorectal cancer; Contraception; Contraceptive; Endometrial cancer; Estrogen; Ovarian cancer; Progestogen

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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