Oral contraceptives and ovarian cancer risk in pre- and post-menopausal women

Abstract

Since their introduction in the late 1950s, oral contraceptives have been used for a multitude of effects, in addition to contraception. Studies have suggested that a protective effect against certain cancers is provided by such method of contraception. However, a negative link between oral contraceptives and cancer still prevails amongst the public. This study aims to analyse whether pre-menopausal and post-menopausal women using oral contraceptives are at a decreased risk of being diagnosed with ovarian cancer, the fourth most common cancer among Maltese females. A systematic search has been carried out to yield valid literature published in English in the last ten years, studying the relationship between any histological type of ovarian cancer in females of all ethnicities using any type of oral contraceptive commercially available. Two systematic reviews, three cohort studies and three case-control studies have been retrieved and critically appraised using the Critical Appraisal Skills Programme tools. It was established that oral contraceptives reduce the risk of ovarian cancer. Risk reduction is increased with an increased duration of use and persists for up to twenty years after stopping oral contraceptives. Additionally, this reduction is not only present in the general population, but also in those carrying the BRCA1 and BRCA2 gene mutations, who are more prone to being diagnosed with ovarian cancer. Despite this protective effect, more research is required to analyse the risk-to-benefit ratio of oral contraceptives, prior to advising their use as a prophylactic method against ovarian cancer, especially in gene mutation carriers. Further local research is also required to evaluate public perception of oral contraceptive use as well as the adequacy of professional knowledge and client education being provided on the subject. Additionally, healthcare professionals as well as potential clients of oral contraceptives should be better educated and made aware of this protective effect.