Hormonal Contraception and Cervical Cancer

According to the American Cancer Society, each year about 13,000 new cases of invasive cervical cancer are diagnosed and more than 4,000 women will die from cervical cancer.

Cervical cancer originates in the lower part of the uterus, the cervix, and can cause abnormal vaginal discharge, pelvic pain, vaginal bleeding, and painful sex.

The World Health Organization states that 99% of cervical cancers are linked to infection with HPV, (human papillomavirus) transmitted through sexual contact. Other risk factors for cervical cancer include smoking, immunodeficiency, and hormonal contraception.

A recent study published in the International Journal of Cancer analyzed the connection between the use of hormonal contraception and the diagnosis of cervical cancer. The cohort study included >20 million person-years, and 3643 incident cervical cancers that occurred in women aged 15 to 49 living in Denmark from 1995 to 2014.

The authors of the study found that the relative risk of ever-users of hormonal birth control was 1.19 compared to women who did not use contraception. Cervical cancer was diagnosed about 19% more often in women who had used birth control at any point compared to women who had never used birth control. In the women who were current or recent users of any hormonal the risk increased to 30%. Longer duration of use was associated with an increased risk of cervical cancer and the risk declined after stopping the use of the artificial hormones.

The use of combined contraceptives( artificial estrogen and progestins) increased the risk of cervical cancer by 40%. Recent use of progestin-only contraceptives was not associated with an increase in cervical cancer.

The authors of the study concluded that their “results indicate that currently available combined contraceptives continue to be positively associated with the risk of cervical cancer, at least among women not vaccinated against HPV. Women wishing to use this method of contraception need to be informed of this risk and encouraged to participate in a cervical screening program, if available. They should also be alert to any symptoms indicative of cervical cancer, and report these promptly to their health care provider. Our findings also reinforce the urgent public health need for global interventions to prevent cervical cancer.”

Complete article Contemporary hormonal contraception and cervical cancer in women of reproductive age – Iversen – 2021 – International Journal of Cancer – Wiley Online Library

Iversen L, Fielding S, Lidegaard Ø, Hannaford PC. Contemporary hormonal contraception and cervical cancer in women of reproductive age. Int J Cancer. 2021 Apr 5. doi: 10.1002/ijc.33585. Epub ahead of print. PMID: 33818778.

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