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Birth Pill Has Prevented 100,000 Deaths From Ovarian Cancer: Study
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Birth Pill Has Prevented 100,000 Deaths From Ovarian Cancer: Study
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Bianca
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Birth Pill Has Prevented 100,000 Deaths From Ovarian Cancer: Study
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January 24, 2008, 08:40:18 pm »
Birth pill has prevented 100,000 deaths from ovarian cancer: study
PARIS (AFP) - The contraceptive pill has prevented some 200,000 cases of ovarian cancer and 100,000 deaths from this disease since its introduction nearly half a century ago, according to a study published in next Saturday's Lancet medical journal.
Over the next decade, around 30,000 extra cases of ovarian cancer are likely to be prevented each year because of the pill, it adds.
The figure are extrapolated from an overview of 45 studies in 21 countries involving 23,000 women diagnosed with ovarian cancer and 87,000 who were otherwise healthy.
Women who had been using oral contraceptives were far less likely to have this form of cancer than counterparts who had not been using the pill, the review found.
And the longer a woman had been on the pill, the more the risk diminished.
Ten years on the pill reduced the risk of ovarian cancer before the age of 75 by a third, and the risk of death by 30 percent.
The benefit was still perceptible, if somewhat reduced, more than 30 years after the woman stopped taking the pill.
The paper, based on long-term research, sheds light on the long-term protective advantage of oral contraceptives when it comes to ovarian cancer.
Other research, though, has found a statistically significant increased risk of cancer of the breast, cervix or central nervous system among users of the pill.
Around 120 million women around the world used the pill in 2002, 80 million of them in developing countries, according to figures cited by The Lancet paper.
It is authored by the Collaborative Group on Epidemiological Studies of Ovarian Cancer, sponsored by the British charity Cancer Research UK.
In the 1960s, doses of estrogen in the pill were typically double those of the 1980s, when the hormone formulation was slimmed down.
Even so, there was no apparent change in the relative risk of ovarian cancer among women who used the pill in the 1960s, 1970s and 1980s.
In an editorial, The Lancet called for the pill to be made available over the counter, rather than restricted by a doctor's prescription, given that, in its view, the benefits for cancer prevention and reproductive health so outweighed the risks.
"We believe the case is now convincing," the British journal said.
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Bianca
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Re: Birth Pill Has Prevented 100,000 Deaths From Ovarian Cancer: Study
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February 16, 2008, 09:20:35 pm »
Birth Control Pill Use Cuts Ovarian Cancer Risk
Summary: Previous studies have shown that taking birth control pills reduces ovarian cancer risk. A comprehensive study published in The Lancet shows just how much.
Oxford University Professor Valerie Beral, along with researchers from the Collaborative Group on Epidemiological Studies of Ovarian Cancer, which includes researchers at the American Cancer Society, analyzed data from 45 studies conducted in the 1960s, '70s, and '80s. They found that the longer a woman took birth control pills, the lower her risk of ovarian cancer.
Why It's Important: Ovarian cancer typically strikes late in life (half of all ovarian cancer cases are found in women over 63), and prognosis is often poor, largely because the disease is usually caught in its later stages. Ovarian cancer symptoms, which include abdominal swelling and digestive problems, are easily confused with other disorders, and there is currently no good screening test available to women.
According to the study, if the current level of oral contraceptive use remains steady, 30,000 cases of ovarian cancer worldwide could be prevented each year. Even better, the protection that comes with the pill seems to start within a year of taking it and increase over time.
What's Already Known: Scientists have known for some time that birth control pills protect against ovarian cancer, and that certain lifestyle factors may affect risk. Age, weight, and a woman's reproductive and family history also appear to play a role in the likelihood a woman might develop ovarian cancer.
However, there's also some data that suggests oral contraceptive use increases the risk of other cancers. Cervical cancer has been linked to long-term birth control pill use, as has breast cancer. (For more information, see "What are the Risk Factors for Cervical Cancer?" and "What are the Risk Factors for Breast Cancer?")
But the picture is complicated. "Oral contraceptives slightly and temporarily increase the risk of breast and cervical cancer. However, the slight increase in breast cancer occurs during and in the 5 years following the use of these contraceptives, and usually at a time and age when risk is very low," said Debbie Saslow, PhD, director of breast and gynecological cancers at the American Cancer Society.
How This Study Was Done: Researchers mined data from 45 studies that included 23,257 women with ovarian cancer and 87,303 without the disease. They determined whether the women had taken birth control pills and for how long.
Scientists then examined the relationship between oral contraceptive use and ovarian cancer diagnosis during the 1960s, 1970s, and 1980s. The amount of estrogen used in birth control pills lessened over the years, and they wanted to see if different estrogen doses had different effects on ovarian cancer risk. They also adjusted for the role of age, ethnicity, education, reproductive history, family cancer history, use of hormone replacement therapy, body mass index, and consumption of tobacco or alcohol, in addition to other factors.
What Was Found: Of the women with ovarian cancer, 31% had taken the pill at some point in their lives, compared to 37% of the women who did not have ovarian cancer. The longer women used the pill, the lower their ovarian cancer risk. Taking the pill for 15 years or more cut a woman's risk of ovarian cancer by 58%; 10-14 years of pill use cut risk by 44%; and 5-9 years of use cut risk by 36%. But even women who used the pill for only 1-4 years saw a benefit; their risk was cut by 22%.
Although the benefit of the pill got weaker the longer it had been since women took it, the protective effect was still significant even 30 or more years after pill use stopped. The researchers did not see a different level of risk reduction from different estrogen doses in the pill.
"It is reasonable to expect that even current lower dose pills will be as protective as the older versions. However, we do not have definitive evidence to show this and won't for many years," said Saslow.
The study authors estimated that during the past 50 years, 200,000 cases of ovarian cancer and 100,000 deaths worldwide have been prevented by oral contraceptive use, and that if use remains at the current level, as many as 30,000 ovarian cancers could be prevented a year.
The Bottom Line: In an editorial accompanying the study, Eduardo L. Franco and Eliane Duarte-Franco of the Departments of Oncology and Epidemiology at McGill University call this study a "major contribution to our understanding of the role of oral contraceptives in the causation or prevention of ovarian cancer." But they caution that calculating the overall effect on women's health will be tricky.
While birth control pills could reduce a woman's risk of developing ovarian cancer by close to 50%, they could also raise the risk for cancers of the breast and cervix. And though these drugs are generally considered safe, they can also cause side effects like blood clots. Birth control pill use should be evaluated on a case-by-case-basis, they say.
The American Cancer Society does not currently make recommendations about taking oral contraceptives as a prevention measure against ovarian cancer, Saslow said.
And while this report is good news in the fight against ovarian cancer, there's a lot more that needs to be done. Only 20% of ovarian cancers are found at an early stage, and just 45% of women who receive an ovarian cancer diagnosis live past 5 years. More research focused on finding ovarian cancer early and improving treatment is needed, as well as on the best management and care for women who see a doctor because they have symptoms that may be associated with ovarian cancer.
For more information, see our detailed guide, Ovarian Cancer.
Citation: "Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls." Published in the January 26, 2008 The Lancet (Vol. 371:303-314). Collaborative Group on Epidemiological Studies of Ovarian Cancer.
"Ovarian cancer and oral contraceptives." Published in the January 26, 2008 The Lancet (Vol. 371:277-278). Authors: Eduardo L. Franco, Eliane Duarte-Franco. Departments of Oncology and Epidemiology, McGill University, Montreal, Quebec, Canada and the Institut National de Sante Publique du Quebec, Montreal, Quebec, Canada.
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