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American Journal of Epidemiology Vol. 136, No. 1: 46-53
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health

research-article

The Risk of Epithelial Ovarian Cancer in Short-Term Users of Oral Contraceptives

Thomas P. Gross1, James J. Schlesselman2, Bruce V. Stadel1, Wei Yu2 and Nancy C. Lee3

1Office of Epidemiology and Biostatistics, Food and Drug Administration Rockville, MD
2Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences Bethesda, MD
3Division of Reproductive Health, Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control Atlanta, GA

Short-term use (less than 1 year) of oral contraceptives has been associated with increased to slightly decreased risks of epithelial ovarian cancer in several studies. To determine what might accoiunt for a statistically significant 40%reduction in risk associated with as little as 3 to 6 months of use, a finding previously reported from the Cancer and Steoid Hormone Study, and to consider the implications for mechanisms of pathogenesis, the authors compared numerous characteristics of short-term users of oral contraceptives (41 cases, 412 controls) with those of never users (242 cases, 1, 517 controls). The reduced risk among short-term users was consistently restricted to women who stopped using oral contraceptives for medical reasons, which were esentially side effects; there was little evidence of aprotective effect among women who stopped for nonmedical reasons. Factors such as age, parity, family history of ovarian cancer, estrogen dose, history of sterilization, and latency (interval from first use) could not account for the finding. These analyses suggest that short-term use of oral contraceptives has little to no effect per se on reducing the risk of epithelial ovarian cancer and that side effects resulting cesation of oral contraceptive use shortly after it was begun may be indicative of factors that are protective against the disease.

contraceptives; oral; ovarian neoplasms


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