Contraception and Cancer – The Scared Teen Who Had Sex
A typical teen afraid of cancer risk compounded by family history.
A 20-year-old woman presents to your office for her well-woman exam. She has recently become sexually active and desires an effective contraceptive method. She has no medical problems, but family history is significant for breast cancer in a maternal aunt at the age of 42. She is worried about getting cancer from taking birth control pills. You discuss with her the risks and benefits of contraceptive pills. You tell her that which of the following neoplasms has been associated with the use of oral contraceptives?
[spoiler] The answer is Hepatic adenoma.
Beginning with high-dose combination contraceptive pills used more than 20 years ago, pills have been studied extensively for a possible association with neoplasia. There is only scant evidence from this experience that use of oral contraceptives increases the risk of any type of cancer. Actually, the progestational component of combination pills (or progestin-only minipills) may confer a protective effect against carcinoma of the breast and endometrium, and avoiding ovulation may decrease the risk of developing ovarian carcinoma.
A slightly higher risk of cervical carcinoma was observed in some studies of users of oral contraceptives. These studies were not controlled, however, for confounding variables such as multiple partners or age at onset of sexual intercourse, and it is generally believed now that any increased risk in contraceptive pill users would be attributable to these other factors and not to the steroids themselves. Although the risk of developing benign liver adenomas is increased somewhat in users of oral contraceptives, the risk of hepatic carcinoma is not increased. [/spoiler]