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American Journal of Epidemiology Vol. 144, No. 3: 281-289
Copyright © 1996 by The Johns Hopkins University School of Hygiene and Public Health
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Oral Contraceptives and Invasive Adenocarcinomas and Adenosquamous Carcinomas of the Uterine Cervix
1From the Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle , WA
Reprint requests to Dr. David B. Thomas, Program in Epidemiology, Fred Hutchinson Cancer Research Center, MP-474, 1124 Columbia St., Seattle, WA 98104.
Data from a hospital-based case-control study collected between 1979 and 1988 in 10 participating hospitals in eight countries were analyzed to determine whether use of combined oral contraceptives atters the risks of invasive adenocarcinomas and adenosquamous carcinomas of the uterine cervix. Information on prior use of oral contraceptives, suspected risk factors for cervical cancer, and history of cytologic screening was ascertained from interviews with 271 women with adenocarcinomas, 106 with adenosquamous carcinomas, and a large pool of hospitalized controls, from which 2,887 were matched to the cases included in this report. History of smoking and anogenrtal warts and blood specimens for measurement of herpes simplex and cytomegalovirus antibodies were obtained from subsets of these women, as was a sexual history from a subset of their husbands. The epidemiologic features and associations with oral contraceptives were similar for adenocarcinoma and adenosquamous carcinoma. For both types combined, risk increased with duration of oral contraceptive use, was highest in recent and current users, and declined with time since cessation of use. These trends in risk were strongest for cancers that occurred in women under age 35 years, and the association with risk was somewhat stronger for high compared with low progestin potency products. The strength of the observed relation with oral contraceptives was about the same as has been observed for invasive squamous cell cervical carcinomas. Women who have used oral contraceptives should be considered at increased risk of adenomatous cervical carcinomas. Am J Epidemiol 1996; 144: 281–9.
adenocarcinoma; carcinoma, adenosquamous; cervix neoplasms; contraceptives, oral
2The data collection centers, with the principal investigator (PI), co-Investigator (Cl), and pathologist (P) at each participating center, in alphabetical order by country, are as follows: University of Sydney, Department of Public Health, Sydney, Australia: Geoffrey Berry (PO, Robert MacLennan (CO, Rodney Shearman (Cl), Tatiana Jelihovsky (P), and Joan Cooper Booth (P). University of Chile, Faculty of Medicine, Hospital Jose Joaquin Aguirre, Department of Obstetrics and Gynecology, and the Ministry of Health, Hospital Salvador, Department of Obstetrics and Gynecology, Santiago, Chile: Ramlro Molina (PI), Luis Martinez (Cl), Oriana Salas (Cl), and Atfredo Dabancens (P). Hospital Universttario, WHO Collaborative Center for Research in Human Reproduction, Cali, Colombia: Alvaro Cuadros (PI) and Nubia Aristizabal (P). Chaim Sheba Medical Center, Department of Clinical Epidemiology, Tel Hashomer, Israel: Baruch Modan (PI), Baine Ron (Cl), and Esther Atfandary (Cl). University of Nairobi, Nairobi Center for Research in Reproduction, Nairobi, Kenya: J. G. Mati pi). Patrick Kenya (CO, Alfred Kungu (P), and D. Gatei (P). Hospital General de Mexico, Mexico City, Mexico: Hector Rodriguez Cuevas (PI), Socorro Benavides Salazar (CO, Antonio Palet (P), and Patricia Ontiveros (P). University of trie Philippines, College of Medicine, Manila, Philippines: Ruben A. Apelo (PI), Julietta R. de la Cruz (Cl), Jose Baens (CI), and Benjamin D. Canlas, Jr. (P). Chiang Mai University, Faculty of Medicine, Chiang Mai, Thailand: Supom Sllpisomkosol (PI), Tieng Pardthaisong (Cl), Viruch Charoeniam (Cl), and Choti Theetranont (P). Chula-longkom University, Faculty of Medicine, Department of Obstetrics and Gynecology, WHO Collaborating Centre for Research in Human Reproduction, Bangkok, Thailand: Banpot Boosiri (PI), Supawat Chutivongse (PI), Pramuan Vlrutamasen (Cl), Chansuda WongsrichanaJai (Cl), and Sermsri Sindhavananda (P). Mahldol University, Faculty of Medicine, Siriraj Hospital, Department of Obstetrics and Gynaecology, Siriraj Family Planning Research Center, Bangkok, Thailand: Supom Koetsawang (PI), Duangdao Rachawat (Cl), and Amom Koetsawang (P). University of Geneva Medical School, Department of Pathology, Geneva, Switzerland: Gustave Riotton (Reference Pathologist). University of Louisville, School of Medicine, Louisville, Kentucky, USA: William M. Christopherson (Reference Pathologist). Baylor College of Medicine, WHO Collaborating Center for Virus Reference and Research, Department of Virology and Epidemiology, Houston, Texas, USA: Joseph L Melnick and Ervin Adam (Virologists). World Heafth Organization, Special Programme of Research, Development and Research Training in Human Reproduction, Geneva, Switzerland: Olav Meirik, Timothy M. M. Farley, and Susan Holck.
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