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Ugeskr Laeger. 1984 Apr 2;146(14):1063-6.

[The pill and cancer of the breast and cervix uteri].

[Article in Danish]



Breast and cervical cancer risk in oral contraceptive (OC) users is analyzed by a review of major US and British case control studies, and Danish mortality data for breast and cervical cancer incidence in the period 1965-1981. Megestrol, a gestagen, was found to cause breast tumors in beagles and was withdrawn from the market. The Boston Collaborative Drug Surveillance Program study compared 102 OC users with breast cancer, aged 31-55, with 132 other patients and found no difference in the 31-45 age group, but a significantly higher incidence in the 46-55 age group. The Royal College of General Practitioners studied 23,000 women and found 75 + 58 cases of cancer, but no significant increase among OC users could be established (though a slight increase was noted in the 30-34 age group). In a Los Angeles retrospective case control study, 314 OC users with breast cancer were compared with 314 users without cancer. The duration of OC use was 49.6 months for cancer patients vs. 39.2 for controls. A slightly higher cancer incidence in the 25 age group was due to pills with higher gestagen content. These findings on progestational potency and cancer risk were discounted by British experts. The link between OC use and cancer or metaplasia of the cervix was studied in 14,000 women in the US by cytological examination of cervix samples. A positive correlation was found; however, other factors (sexual habits) invalidated these results. The Oxford Family Planning Association studied 7000 OC users and 3000 IUD users and found 64 dysplasias and 59 carcinomas, 97 of which were in OC users, vs. 26 in IUD users. In addition, there were 13 cases of invasive cancer in OC users vs. none in IUD users. The estrogen content of the pills was 50 mcg or more. These findings have also been questioned by British peers on methodological grounds. The mortality trend in breast and cervic cancer in Denmark over the last 16 years for all women and for the 15-49 age group does not support the hypothesis that OCs have increased the risk of these diseases.

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