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Cervical cancer and use of hormonal contraceptives: a systematic review.

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Title: Cervical cancer and use of hormonal contraceptives: a systematic review.
Authors: Smith JS (AUTHOR), Green J (AUTHOR), Berrington de Gonzalez A (AUTHOR), Appleby P (AUTHOR), Peto J (AUTHOR), Plummer M (AUTHOR), Franceschi S (AUTHOR), Beral V (AUTHOR), Smith, Jennifer S (AUTHOR), Green, Jane (AUTHOR), Berrington de Gonzalez, Amy (AUTHOR), Appleby, Paul (AUTHOR), Peto, Julian (AUTHOR), Plummer, Martyn (AUTHOR), Franceschi, Silvia (AUTHOR), Beral, Valerie (AUTHOR)
Source: Lancet. 4/5/2003, Vol. 361 Issue 9364, p1159-1167. 9p.
Abstract: Background: Human papillomavirus (HPV) is believed to be the most important cause of cervical cancer. Recent studies suggest that long duration use of oral contraceptives increases the risk of cervical cancer in HPV positive women.Methods: Results from published studies were combined to examine the relationship between invasive and in situ cervical cancer and duration and recency of use of hormonal contraceptives, with particular attention to HPV infection.Findings: 28 eligible studies were identified, together including 12531 women with cervical cancer. Compared with never users of oral contraceptives, the relative risks of cervical cancer increased with increasing duration of use: for durations of approximately less than 5 years, 5-9 years, and 10 or more years, respectively, the summary relative risks were 1.1 (95% CI 1.1-1.2), 1.6 (1.4-1.7), and 2.2 (1.9-2.4) for all women; and 0.9 (0.7-1.2), 1.3 (1.0-1.9), and 2.5 (1.6-3.9) for HPV positive women. The results were broadly similar for invasive and in situ cervical cancers, for squamous cell and adenocarcinoma, and in studies that adjusted for HPV status, number of sexual partners, cervical screening, smoking, or use of barrier contraceptives. The limited available data suggest that the relative risk of cervical cancer may decrease after use of oral contraceptives ceases. However, study designs varied and there was some heterogeneity between study results.Interpretation: Although long duration use of hormonal contraceptives is associated with an increased risk of cervical cancer, the public health implications of these findings depend largely on the extent to which the observed associations remain long after use of hormonal contraceptives has ceased, and this cannot be evaluated properly from published data. [ABSTRACT FROM AUTHOR]
Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Cervical cancer and use of hormonal contraceptives: a systematic review.
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  Data: <searchLink fieldCode="AR" term="%22Smith+JS%22">Smith JS</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Green+J%22">Green J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Berrington+de+Gonzalez+A%22">Berrington de Gonzalez A</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Appleby+P%22">Appleby P</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Peto+J%22">Peto J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Plummer+M%22">Plummer M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Franceschi+S%22">Franceschi S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Beral+V%22">Beral V</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Smith%2C+Jennifer+S%22">Smith, Jennifer S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Green%2C+Jane%22">Green, Jane</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Berrington+de+Gonzalez%2C+Amy%22">Berrington de Gonzalez, Amy</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Appleby%2C+Paul%22">Appleby, Paul</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Peto%2C+Julian%22">Peto, Julian</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Plummer%2C+Martyn%22">Plummer, Martyn</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Franceschi%2C+Silvia%22">Franceschi, Silvia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Beral%2C+Valerie%22">Beral, Valerie</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Lancet%22">Lancet</searchLink>. 4/5/2003, Vol. 361 Issue 9364, p1159-1167. 9p.
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  Data: <bold>Background: </bold>Human papillomavirus (HPV) is believed to be the most important cause of cervical cancer. Recent studies suggest that long duration use of oral contraceptives increases the risk of cervical cancer in HPV positive women.<bold>Methods: </bold>Results from published studies were combined to examine the relationship between invasive and in situ cervical cancer and duration and recency of use of hormonal contraceptives, with particular attention to HPV infection.<bold>Findings: </bold>28 eligible studies were identified, together including 12531 women with cervical cancer. Compared with never users of oral contraceptives, the relative risks of cervical cancer increased with increasing duration of use: for durations of approximately less than 5 years, 5-9 years, and 10 or more years, respectively, the summary relative risks were 1.1 (95% CI 1.1-1.2), 1.6 (1.4-1.7), and 2.2 (1.9-2.4) for all women; and 0.9 (0.7-1.2), 1.3 (1.0-1.9), and 2.5 (1.6-3.9) for HPV positive women. The results were broadly similar for invasive and in situ cervical cancers, for squamous cell and adenocarcinoma, and in studies that adjusted for HPV status, number of sexual partners, cervical screening, smoking, or use of barrier contraceptives. The limited available data suggest that the relative risk of cervical cancer may decrease after use of oral contraceptives ceases. However, study designs varied and there was some heterogeneity between study results.<bold>Interpretation: </bold>Although long duration use of hormonal contraceptives is associated with an increased risk of cervical cancer, the public health implications of these findings depend largely on the extent to which the observed associations remain long after use of hormonal contraceptives has ceased, and this cannot be evaluated properly from published data. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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