The Reduction in Risk of Ovarian Cancer Associated with Oral-Contraceptive Use

TLDR

Oral contraceptive use has been linked to lower ovarian cancer risk, but it is unclear whether this effect differs by formulation or cancer histology. This study aimed to clarify that association using data from the Cancer and Steroid Hormone Study case‑control design. Between 1980 and 1982, 546 women aged 20‑54 with ovarian cancer were enrolled from eight population‑based registries, and 4,228 matched controls were selected from the same regions. Women who had used oral contraceptives had a 40 % lower risk of epithelial ovarian cancer (RR = 0.6, 95 % CI 0.5‑0.7); the protective effect appeared after as little as 3‑6 months of use, persisted for 15 years, and was independent of formulation and histologic subtype, though nonepithelial cancers could not be adequately assessed. N Engl J Med 1987; 316:650–5.

Abstract

Although several studies have reported that the use of oral contraceptives decreases the risk of ovarian cancer, it is not clear whether the effect varies according to the oral-contraceptive formulation or the histologic type of cancer. To characterize this association more fully, we used data from a case-control study, the Cancer and Steroid Hormone Study. From 1980 to 1982, 546 women 20 to 54 years of age with ovarian cancer were enrolled from eight population-based cancer registries. The controls were 4228 women selected from the same areas. Women who had used oral contraceptives had a risk of epithelial ovarian cancer of 0.6 (95 percent confidence interval, 0.5 to 0.7) as compared with those who had never used them. This protective effect was seen in women who had used oral contraceptives for as little as three to six months, and it continued for 15 years after use ended; it was independent of the specific oral-contraceptive formulation and of the histologic type of epithelial ovarian cancer. (We could not adequately assess the association with nonepithelial ovarian cancers because of an insufficient number of cases.) We conclude that the use of oral contraceptives decreases the risk of epithelial ovarian cancer. (N Engl J Med 1987; 316:650–5.)