Last Modified: May 31, 2003
Dear OncoLink "Ask The Experts,"
I was diagnosed with HPV. I have read several studies showing that having HPV increases your chances of cervical cancer. Recently, I read that being on birth control and having HPV will increase your chances by 60%. My question is should I stop taking birth control due to the fact of having HPV? Or is the percentage not as significant as it seems.
A recent study did show that patients with HPV infections who had used oral contraceptive pills for more than 5 years had a four-fold higher risk of developing cervical cancer. However, most of the patients in the study were from developing countries where cervical cancer screening (Pap tests) is not performed regularly. Also, not everyone who is positive for HPV infection will develop cervical cancer: keep in mind that while 20 million people in the United States are infected with the HPV virus, only about 12,000 women a year are diagnosed with cervical cancer. Additionally, about 60% of patients with findings of HPV on their Pap tests will clear the infection without additional treatment. Also remember that while a "four-fold higher risk" sounds like a lot, if the baseline risk is less than 1 in 100 patients, a four-times higher risk is still less than 4 in 100.
While this study shows that there may be some relationship between hormone use and promotion of cervical cancer, it cannot be interpreted to mean that all patients with HPV should discontinue their oral contraceptive pills. Oral contraceptives have some benefits and are also felt to provide protection against endometrial and ovarian cancers. Patients with HPV may certainly consider other forms of non-hormonal birth control, but at this time, no recommendation exists to mandate changing. Certainly, all patients should undergo routine Pap testing.