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Oral contraceptives and neoplasia : report of a WHO scientific group [meeting held in Geneva from 3 to 5 December 1990]

By: WHO Scientific Group on Oral Contraceptives and Neoplasia
Contributor(s): World Health Organization
Material type: materialTypeLabelBookSeries: WHO technical report series ; 817 | Publisher: Geneva : World Health Organization, 1992Description: 46 p ISBN: 9241208171 Title translated: Contraception orale et tumeurs : rapport de' un Groupe scientifique del' OMS [réuni à Genève, 3-5 décembre 1990]; Anticonceptivos orales y neoplasia : informe de un grupo científico de la OMS [se reunió en Ginebra del 3 al 5 de diciembre de 1990] Subject(s): Contraceptives, Oral, Combined -- adverse effects | Neoplasms -- chemically induced | Cancer and its ControlNLM classification: QZ 202 Online resources: Full text now in IRIS | Full text now in IRIS | Full text now in IRIS Abstract: Reports the conclusions of a WHO Study Group convened to evaluate the strength of evidence linking use of combined oral contraceptives to the risk of neoplasia in women. The group, which included fifteen specialists in cancer research, epidemiology, and obstetrics and gynaecology, was specifically concerned with the need to resolve several inconsistencies in reported findings that have created confusion about the safety of oral contraceptives. The possibility that studies conducted in industrialized countries may not be relevant to conditions in the developing world was also of central concern. Close to 200 studies, including a WHO collaborative study conducted in eight developing and three developed countries, were critically assessed. The opening section addresses the many complex methodological problems that have made the interpretation of study results so difficult and controversial. Against this background, the main part of the report provides separate evaluations for neoplasia of the ovary, uterine corpus, uterine cervix, breast and liver. Other types of neoplasia, where some studies have suggested a link with the use of contraceptives, are also assessed. These include malignant melanoma of the skin, colorectal cancer, cancer of the gallbladder and extrahepatic bile ducts, and pituitary tumours. For some cancers, clear conclusions could be reached: use of combined oral contraceptives protects against epithelial ovarian cancer, reduces the risk of endometrial cancer, and does not influence the risk of either malignant melanoma of the skin or pituitary tumours. For neoplasia of the liver, data on short-term use of oral contraceptives, including evidence from studies conducted in populations where infection with hepatitis B virus is common, showed no association with increased risk; data on the effects of long-term use were inadequate for evaluation. While the report found no overall association between oral contraceptive use and the risk of breast cancer, a number of recent studies were noted to show a weak association between long-term use of oral contraceptives and breast cancer diagnosed before the age of 36, an age group which represents a very small proportion of all breast cancers. For women over the age of 45, when breast cancer becomes more common, the report found no evidence of an increased risk of breast cancer associated with prior use of oral contraceptives. Moreover, no evidence of a decreased or increased risk of breast cancer was found in either low-risk or high-risk subgroups, such as women with a family history of breast cancer. For other cancers, evidence of an association was either weak or inconsistent. The report concludes that currently available evidence about neoplasia does not provide grounds for revising the generally favourable assessment of the benefits of oral contraception.
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Reports the conclusions of a WHO Study Group convened to evaluate the strength of evidence linking use of combined oral contraceptives to the risk of neoplasia in women. The group, which included fifteen specialists in cancer research, epidemiology, and obstetrics and gynaecology, was specifically concerned with the need to resolve several inconsistencies in reported findings that have created confusion about the safety of oral contraceptives. The possibility that studies conducted in industrialized countries may not be relevant to conditions in the developing world was also of central concern. Close to 200 studies, including a WHO collaborative study conducted in eight developing and three developed countries, were critically assessed. The opening section addresses the many complex methodological problems that have made the interpretation of study results so difficult and controversial. Against this background, the main part of the report provides separate evaluations for neoplasia of the ovary, uterine corpus, uterine cervix, breast and liver. Other types of neoplasia, where some studies have suggested a link with the use of contraceptives, are also assessed. These include malignant melanoma of the skin, colorectal cancer, cancer of the gallbladder and extrahepatic bile ducts, and pituitary tumours. For some cancers, clear conclusions could be reached: use of combined oral contraceptives protects against epithelial ovarian cancer, reduces the risk of endometrial cancer, and does not influence the risk of either malignant melanoma of the skin or pituitary tumours. For neoplasia of the liver, data on short-term use of oral contraceptives, including evidence from studies conducted in populations where infection with hepatitis B virus is common, showed no association with increased risk; data on the effects of long-term use were inadequate for evaluation. While the report found no overall association between oral contraceptive use and the risk of breast cancer, a number of recent studies were noted to show a weak association between long-term use of oral contraceptives and breast cancer diagnosed before the age of 36, an age group which represents a very small proportion of all breast cancers. For women over the age of 45, when breast cancer becomes more common, the report found no evidence of an increased risk of breast cancer associated with prior use of oral contraceptives. Moreover, no evidence of a decreased or increased risk of breast cancer was found in either low-risk or high-risk subgroups, such as women with a family history of breast cancer. For other cancers, evidence of an association was either weak or inconsistent. The report concludes that currently available evidence about neoplasia does not provide grounds for revising the generally favourable assessment of the benefits of oral contraception.

chi eng fre rus spa.

WHODOC

WHO monograph

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