Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection: the IARC multicentric case-control study
Víctor Moreno, F Xavier Bosch, Nubia Muñoz
Chris J L M Meijer, Jan M M Walboomers , Rolando Herrero, Silvia Franceschi, International Agency for Research on Cancer. Multicentric Cervical Cancer Study Group , Keerti V Shah
Use of oral contraceptives could increase risk of cervical cancer; however the effect of human papillomavirus (HPV), the main cause of cervical cancer, is not usually taken into account. We aimed to assess how use of oral contraceptives affected risk of cervical cancer in women who tested positive for HPV DNA.
Methods
We pooled data from eight case-control studies of patients with histologically confirmed invasive cervical carcinoma (ICC) and from two studies of patients with carcinoma in situ (ISC). Information about use of oral contraceptives was obtained from personal interviews. Effects were estimated as odds ratios, with logistic-regression models adjusted for possible confounders.
Findings
1465 of 1561 (94%) patients with ICC, 211 of 292 (72%) with ISC, and 255 of 1916 (13%) controls were positive for HPV DNA. Compared with never-users, patients who had used oral contraceptives for fewer than 5 years did not have increased risk of cervical cancer (odds ratio 0.73; 95% CI 0.52-1.03). The odds ratio for use of oral contraceptives was 2.82 (95% CI 1.46-5.42) for 5-9 years, and 4.03 (2.09-8.02) for use for 10 years or longer, and these risks did not vary by time since first or last use.
Interpretation
Long-term use of oral contraceptives could be a cofactor that increases risk of cervical carcinoma by up to four-fold in women who are positive for cervical HPV DNA. In the absence of worldwide information about HPV status, extra effort should be made to include long-term users of oral contraceptives in cervical screening programmes.
oral contraceptives cervical cancer risk HPV positive women, long-term oral contraceptive use cervical carcinoma cofactor, human papillomavirus oral contraceptive interaction cervical cancer, IARC multicentric case-control study cervical cancer contraceptives, Moreno Muñoz Bosch oral contraceptives HPV cervical cancer, duration oral contraceptive use invasive cervical carcinoma risk, HPV DNA positive women hormonal contraception cancer risk, oral contraceptive cervical screening programme recommendations, carcinoma in situ oral contraceptive use odds ratio, pooled case-control studies cervical cancer hormonal contraception
PMID 11943255 11943255 DOI 10.1016/S0140-6736(02)08150-3 10.1016/S0140-6736(02)08150-3
Cite this article
Moreno, V., Bosch, F. X., Muñoz, N., Meijer, C. J. L. M., Shah, K. V., Walboomers, J. M. M., Herrero, R., Franceschi, S., & International Agency for Research on Cancer. Multicentric Cervical Cancer Study Group (2002). Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection: the IARC multicentric case-control study. Lancet (London, England), 359(9312), 1085-1092. https://doi.org/10.1016/S0140-6736(02)08150-3
Moreno V, Bosch FX, Muñoz N, Meijer CJLM, Shah KV, Walboomers JMM, et al. Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection: the IARC multicentric case-control study. Lancet. 2002;359(9312):1085-1092. doi:10.1016/S0140-6736(02)08150-3
Moreno, V., et al. "Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection: the IARC multicentric case-control study." Lancet (London, England), vol. 359, no. 9312, 2002, pp. 1085-1092.
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