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© 1990 Oxford University Press

research-article

Oral Contraceptive Use and Risk of Invasive Cervical Cancer

LOUISE A BRINTON*, WILLIAM C REEVES**, MARIA M BRENES**, ROLANDO HERRERO{dagger}, ROSA C DE BRITTON{ddagger}, EDUARDO GAITAN§, FRANCISCO TENORIOboxV, MARIANA GARCIA** and WILLIAM E RAWLS

*Environmental Epidemiology Branch, National Cancer Institute Bethesda MD, USA.
**Gorgas Memorial Laboratory Panama City, Republic of Panama
{dagger}Unidad Nacional de Cancerologia, Caja Costarricense de Seguro Social San Jose, Costa Rica.
{ddagger}Instituto Oncologico Nacional, Republica de Panama
§Division de Epidemiologia, Instituto Nacional de Cancerologia Bogota, Colombia.
boxVHospital de Oncologia Nacional, Instituto Mexicano del Seguro Social Mexico City, Mexico.
¶Molecular Virology and Immunology, Department of Pathology, McMaster University Hamilton, Ontario, Canada.

Brinton L A (Environmental Epidemiology Branch, National Cancer Institute, Executive Plaza North, Rm 443, Bethesda, MD 20892, USA) Reeves W C, Brenes M M, Herrero R+, de Britton R C, Gaitan E, Tenorio F, Garcia M and Rawls W E. Oral contraceptive use and risk of invasive cervical cancer. International Journal of Epidemiology 1990, 19: 4–11.

A case-control study of 759 invasive cervical cancer patients and 1430 controls in Panama, Costa Rica, Colombia and Mexico enabled an evaluation of risk in relation to oral contraceptive use. Overall use was associated with a 21% nonsignificant elevation in risk, with some further increases in risk for more extensive durations of use. Although risks were similar for recent and non-recent users (RRs = 1.3 versus 1.2), recent long-term users were at highest risk (RR for 5+ years use = 1.7, 95% Cl 1.1–2.6). Relationships were similar for women with and without a recent Pap smear, arguing against detection bias. There was little evidence that other risk factors, including smoking and detection of human papillomaviruses (HPV), altered the effects of oral contraceptives. The risk associated with oral contraceptives was significantly increased for adenocarcinomas (RR = 2.2), whereas for squamous cell tumours the effect was minimal (RR =1.1). These results provide some support for an adverse effect of oral contraceptives on cervical cancer risk, although possibly limited only to a subpopulation of cases.

Revised 1 May 1989


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