Monday, January 28, 2008

Use of Oral Contraceptives for Prevention of Ovarian Cancer Draws Controversy

According to an analysis published in the January 25 issue of the Lancet, the use of oral contraceptives is shown to reduce the risk of ovarian cancer significantly. The evidence is so strong that there is advocacy for over the counter purchase of oral contraceptives.

Ovarian cancer is aggressive and deadly, making it a recent research focus. The dilemma involving this current analysis involves concerns over past studies that show an increase in breast and cervical cancer with hormone use. Obviously, the risk benefit ratio of taking oral contraceptives for ovarian cancer prevention must be weighed.

The current study encourages rapid dissemination of this information in an effort to combat the negativity associated with oral contraceptive use, and though over the counter purchase is advocated, accompanying commentaries urge caution. Experts believe that safe use of oral contraceptives requires close monitoring and counseling, though agreement exists that the pill should be made more readily available to women worldwide.

The editorial is already drawing controversy. Dr. José-María Simón Castellví, president of the World Federation of the Catholic Medical Association, calls the editorial “definitively irresponsible" because of the association between breast and colorectal cancer seen with oral contracetpives; noting a 2005 statement from the World Health Organization's International Agency for Research on Cancer.

The Lancet so strongly endorsed the use of oral contraceptives for ovarian cancer prevention that they term this study “hard hitting”, with “public health implications”, and describe this as “unequivocal good news”.

To summarize the results, 100.000 women from 21 countries were studied. Age was not a factor in the outcome. After ten years of oral contraceptive use, the results translate to the following: Among 5000 women using oral contraceptives for 1 year, roughly 2 cases of ovarian cancer and 1 death from ovarian cancer before the age of 75 years would be avoided.

The controversy and varying opinions surrounding this analysis certainly make the issue a bit confusing - for consumer and healthcare providers alike.. It seems that women are going to have to make their own choices about whether they want to take oral contraceptives to prevent ovarian cancer. Many factors will have to be considered. I urge you to remain informed and proactive regarding all of your healthcare choices.

Ref: Lancet. 2008;371:275, 277-278, 303-314.

ZE08012808 - 2008-01-28