UI - 11962261
AU - Fleischauer AT; Olson SH; Mignone L; Simonsen N; Caputo TA; Harlap S
Dietary antioxidants, supplements, and risk of epithelial ovarian
SO - Nutr Cancer 2001;40(2):92-8
AD - Dept. of Epidemiology, CB 7435, School of Public Health, University of
North Carolina, Chapel Hill, NC 27599, USA.
Several studies of dietary and serum antioxidant micronutrients
(vitamins A, C, and E and beta-carotene) suggest that higher levels may
be protective for ovarian cancer. None of these has examined
supplements. We used a food frequency questionnaire and additional
questions on supplements to study 168 histologically confirmed
epithelial ovarian cancer cases, 159 community controls, and 92
hospital-based controls. Antioxidant consumption from diet or
supplements was calculated in milligrams or international units per day.
In multivariate analyses using only community controls, the highest
levels of intake of vitamins C and E from supplements were protective:
odds ratio (OR) = 0.40 [95% confidence interval (CI) = 0.21-0.78] and OR
= 0.33 (95% CI = 0.18-0.60), respectively. Consumption of antioxidants
from diet was unrelated to risk. In analyses combining antioxidant
intake from diet and supplements, vitamins C (> 363 mg/day) and E (> 75
mg/day) were associated with reduced risks: OR = 0.45 (95% CI =
0.22-0.91) and OR = 0.44 (95% CI = 0.21-0.94), respectively. Results
were similar, with some attenuation toward the null, in analyses
combining both control groups. The levels of vitamins C and E associated
with the protective effect were well above the current US Recommended
Dietary Allowances. These findings support the hypothesis that
antioxidant vitamins C and E from supplements are related to a reduced
risk of ovarian cancer.
UI - 12243426
AU - Ashkar K; Bulbul M; Sharara A; Hourani M; Hamadeh GN
Cancer screening for the primary care physician.
SO - J Med Liban 2001 Sep-Oct;49(5):298-302
AD - American University of Beirut-Medical Center, Department of Family
Medicine, Lebanon. firstname.lastname@example.org
Cancer screening guidelines are developed by numerous agencies. These
guidelines are often conflicting leaving the primary care physician in a
difficult position. He (she) is requested to choose the best test for
his or her patients taking into consideration the principles of
screening, the test cost and most importantly the patient's emotional
and physical well-being. Screening for some cancers, like lung cancer,
has been considered of no benefit. Other cancers, like breast, colon,
cervix and prostate, have been the subject of numerous recommendations:
For breast cancer, clinical examination and mammography are recommended
every 1-2 years for women between 50 to 70 years. For cervical cancer,
PAP smear is suggested every 1-3 years and for colorectal cancer, a
yearly fecal occult blood, sigmoidoscopy or colonoscopy every 5-10
years. Annual serum prostate specific antigen (PSA) and digital rectal
examination screening for prostate cancer are still controversial.
UI - 2187166
AU - Grio R; Piacentino R; Cellura A; Caccuri D; Zaccheo F; Baccarini G;
Marchino GL; Borgarino S; Fuda G
[Hormonal contraception using estroprogestins]
SO - Minerva Ginecol 1990 Mar;42(3):49-53
AD - Istituto di Ginecologia e Ostetricia Cattedra A, Universita degli Studi
Today the estroprogestagen pill is the most valid method of
contraception given that its benefits far outweigh its risks. The paper
stresses the importance of a thorough anamnestic, clinical and
laboratory examination so as to obtain correct and safe steroid
contraception. The efficacy and excellent tolerance of the combined
method currently make it the most widespread form of oral contraception.
UI - 2256863
AU - Thomas I; Wright G; Ward B
The effect of condom use on cervical intraepithelial neoplasia grade I
SO - Aust N Z J Obstet Gynaecol 1990 Aug;30(3):236-9
AD - Royal Women's Hospital, Brisbane, Queensland.
A prospective, controlled study of condom use in patients with
histologically-proven CIN I was undertaken. Forty-six patients were
studied, 22 by random allocation and 24 by nonrandom allocation to
either condom use or non-condom use for 6 months. At the end of this
time, patients were reassessed cytologically, colposcopically and
histologically. There was no significant difference between the groups
with respect to outcome. Six patients' lesions (13%) progressed in this
period, 5 (11%) to CIN III. Condom usage is not an effective treatment
for CIN I.
UI - 2083301
AU - Daling JR; Weiss NS
Are barrier methods protective against cervical cancer?
SO - Epidemiology 1990 Jul;1(4):261-2
UI - 2083303
AU - Hildesheim A; Brinton LA; Mallin K; Lehman HF; Stolley P; Savitz DA;
Barrier and spermicidal contraceptive methods and risk of invasive
SO - Epidemiology 1990 Jul;1(4):266-72
AD - Environmental Epidemiology Branch, National Cancer Institute, Bethesda,
The effects of barrier and spermicidal methods of contraception on
cervical cancer risk were examined by studying 479 cases of
histologically confirmed invasive cervical cancer cases and 788 random
digit dialing controls. In addition to a detailed history of
contraceptive practices, information was available on numerous potential
confounders, including demographic characteristics, sexual behavior,
reproductive factors, Pap smear screening history, and smoking. After
adjustment for relevant confounders, diaphragm and condom use were found
not to be significantly associated with risk of cervical cancer.
Although there was a small reduction in risk (OR = 0.8) associated with
long-term use (5+ years) of the diaphragm, the effect appeared to relate
to concomitant spermicide use, since there was evidence of further
decreases in risk for women using spermicides alone for extended periods
(OR = 0.7 for 5+ years). Effects were only seen among subjects of higher
income and education levels, suggesting that patterns of usage may be
important. The potential ability of spermicides to reduce cervical
cancer risk by neutralizing viral agents warrants further attention.
UI - 2092241
AU - Peterson HB; Lee NC
Long-term health risks and benefits of oral contraceptive use.
SO - Obstet Gynecol Clin North Am 1990 Dec;17(4):775-88
AD - Division of Reproductive Health, Center for Chronic Disease Prevention
and Health Promotion, Centers for Disease Control, Atlanta, Georgia.
The contraceptive effect of oral contraceptive use provides an important
health benefit, particularly in developing countries, where the risks of
pregnancy and childbearing are increased. Several important
noncontraceptive health benefits of oral contraceptive use include the
prevention of endometrial and ovarian cancers. Data are generally
reassuring concerning the risks of oral contraceptive use, which include
cardiovascular disease and breast and cervical cancer.
UI - 2130948
AU - Yang M; Prasad RN; Ratnam SS
Contraception: barriers and spermicides, periodic abstinence, and
SO - Curr Opin Obstet Gynecol 1990 Aug;2(4):524-30
AD - National University Hosital, University of Singapore.
UI - 1868732
AU - Stanford JL
Oral contraceptives and neoplasia of the ovary.
SO - Contraception 1991 Jun;43(6):543-56
AD - Fred Hutchinson Cancer Research Center, Program in Epidemiology (MP-474)
Seattle, Washington 98104.
Epidemiologic literature on oral contraceptives in relation to primary
ovarian cancer is reviewed. Compared to women who have never used oral
contraceptives, women who have ever taken oral contraceptives have about
a 30% reduction in risk for epithelial ovarian cancer, and five or more
years of use is associated with a 50% reduction in risk. The protective
effect of oral contraceptives persists for ten or more years after use
is discontinued, and becomes apparent several years after beginning use.
Effects of oral contraceptives are similar for malignant and borderline
malignant epithelial ovarian cancer. Reduced risks among oral
contraceptive users have been observed for all major histologic subtypes
of epithelial ovarian cancer, and for women from developed and
developing countries. Risk estimates for epithelial ovarian cancer in
relation to oral contraceptive use stratified by age at diagnosis or
parity are not uniform across studies. No consistent protective effect
is apparent for non-epithelial ovarian tumors or benign ovarian tumors,
including teratomas and cystadenomas, although limited data are
available on the relationship between oral contraceptives and these
neoplasms. Several areas for future research are described.
UI - 1868733
AU - Schlesselman JJ
Oral contraceptives and neoplasia of the uterine corpus.
SO - Contraception 1991 Jun;43(6):557-79
AD - Department of Preventive Medicine and Biometrics, Uniformed Services
University of the Health Sciences, Bethesda, Maryland 20814.
Effects of oral contraception on neoplasia of the uterine corpus are
reviewed on the basis of epidemiologic studies reported to date. A
duration-related protective effect against endometrial cancer occurs
from use of combined oral contraceptives, those in which each active
pill contains both estrogen and progestogen. The risk before age 60
years is reduced by about 38% with two years of use; use of combined OCs
for 4, 8, and 12 years, respectively, confers an estimated 51%, 64%, and
70% reduction in endometrial cancer risk. The protective effect appears
not to be diminished by discontinued use, even 15 or more years after
stopping. Whether protection continues throughout the entire
postmenopausal period, even in the presence of long-term hormone
replacement therapy, remains to be seen. Use of combined OCs may protect
against uterine leiomyomas ("fibroids"), but the evidence is not
conclusive. The few findings about effects of oral contraception on the
risk of adenomatous hyperplasia are of uncertain validity. Only one
study, with few patients, has considered oral contraception in relation
to uterine sarcomas.
UI - 1868734
AU - Brinton LA
Oral contraceptives and cervical neoplasia.
SO - Contraception 1991 Jun;43(6):581-95
AD - Environmental Epidemiology Branch, National Cancer Institute, Bethesda,
Although initial studies examining the relationship of oral
contraceptives to risk of cervical neoplasia were reassuring, more
recent studies provide some evidence of a positive relationship,
particularly for long-term usage. Results, however, are difficult to
interpret, because of a variety of methodologic complexities, including
potential sources of confounding and bias. Sexual behavior and Pap smear
screening have been identified as important confounders, but in several
well-controlled studies residual excess risks of nearly 2-fold persist
for users of 5 or more years. A possible promotional effect of oral
contraceptives is suggested by higher risks associated with recent
usage. There also is some suggestion of a stronger effect for
adenocarcinomas than for squamous cell tumors. A relationship is
biologically possible, given findings of hormone receptors in cervical
tissue and the fact that oral contraceptives have been found to induce
cervical hyperplasia. In addition, oral contraceptives may induce
proliferation of the human papillomaviruses, the leading suspect agent
for cervical cancer. Although a number of lines of evidence support a
relationship of oral contraceptives to cervical cancer risk, firm
conclusions await the results of additional studies that specifically
address some of the methodologic shortcomings of previous
investigations. In particular, additional follow-up studies are needed
to define the effect of oral contraceptives on the natural history of
UI - 1868738
AU - Thomas DB
The WHO Collaborative Study of Neoplasia and Steroid Contraceptives: the
influence of combined oral contraceptives on risk of neoplasms in
developing and developed countries.
SO - Contraception 1991 Jun;43(6):695-710
AD - Fred Hutchinson Cancer Research Center, Seattle, WA 98104.
A hospital-based case-control study was conducted in eight developing
and three developed countries to determine whether use of combined oral
contraceptives alters risks of various cancers. An observed trend of
increasing risk of invasive cervical cancer with duration of use may not
represent a causal relationship and is the subject of further study.
Decreased risks of ovarian and endometrial carcinomas in users likely
indicate a protective effect of oral contraceptives, the degree of which
was similar in developing and developed countries. A small increase in
risk of breast cancer in recent and current users was found to be
somewhat greater in developing than developed countries. Both causal and
non-causal interpretations of this finding have been offered. No
associations were found between oral contraceptives and in situ
cervical, hepatocellular, cholangio, or gallbladder carcinomas, or
uterine sarcomas; but the power of this study to detect alterations in
risks of these neoplasms in long-term users was low.
UI - 1815841
AU - Presl J
[Favorable effects of oral estrogen-progestin contraception]
SO - Cesk Gynekol 1991 Nov;56(5-6):350-2
AD - Ustav pro peci o matku a dite, Praha-Podoli.
UI - 1678377
AU - Grimes DA
Neoplastic effects of oral contraceptives.
SO - Int J Fertil 1991;36 Suppl 1():19-24
AD - Department of Obstetrics and Gynecology, University of Southern
California School of Medicine, Los Angeles.
The potential association between the use of oral contraceptives (OCs)
and certain types of cancer remains an important concern. Epidemiologic
studies published over the past decade indicate that the overall risk of
breast cancer is not increased among women exposed to OCs. Some studies
have suggested an increased risk among younger women with long-term use,
and this issue requires further study. OCs confer significant protection
against endometrial and ovarian cancers, and the effect is
duration-related: longer use is more protective. In the largest study to
date, the protection against these two types of cancer persisted for at
least 15 years after OCs were discontinued. Several studies have linked
long-term OC use with an increased risk of cervical cancer or its
precursors, but methodologic difficulties in studying cervical cancer
are such that the potential association with OC use may never be
clarified. A large international study has found no association between
OC use for any duration and liver cancer. Neither malignant melanoma nor
pituitary adenoma appears to be linked to OC use. In summary, OCs
protect against endometrial and ovarian cancers and have no overall
effect on the risk of breast cancer. Women using OCs should have regular
UI - 1559340
AU - Petitti DB; Porterfield D
Worldwide variations in the lifetime probability of reproductive cancer
in women: implications of best-case, worst-case, and likely-case
assumptions about the effect of oral contraceptive use.
SO - Contraception 1992 Feb;45(2):93-104
AD - Department of Family and Community Medicine, University of California,
San Francisco School of Medicine 94143.
Cancer incidence in countries representative of three patterns of
reproductive cancer and age-specific mortality was used to estimate the
effect of oral contraceptive use on the lifetime probability of
reproductive cancer under three sets of assumptions about the effects of
oral contraceptives. Under the set of assumptions considered likely,
oral contraceptives were estimated to reduce or increase only slightly
the lifetime probability of any reproductive cancer in each setting.
Under worst-case assumptions, oral contraceptives were estimated to
increase the lifetime probability of reproductive cancer only modestly
in settings with low cancer rates and in settings with high rates of
breast, ovarian, and endometrial cancer, but it might have a large
impact on lifetime probability of reproductive cancer in settings with
high cervical cancer rates. Under best-case assumptions, oral
contraceptives were estimated to decrease the lifetime probability of
reproductive cancer in each setting; this reduction was estimated to be
greatest in settings where endometrial and ovarian cancer incidence are
UI - 1622631
AU - Spicer DV; Pike MC
The prevention of breast cancer through reduced ovarian steroid
SO - Acta Oncol 1992;31(2):167-74
AD - University of Southern California School of Medicine, Department of
Preventive Medicine, Los Angeles 90033-9987.
Analysis of epidemiologic data on cancers of the breast, ovary and
endometrium; the effects of endogenous hormones on cell proliferation;
and current carcinogenesis concepts, suggest that hormonal
contraceptives can be developed that will reduce lifetime risk of all 3
cancers. The 'unopposed-estrogen hypothesis' accounts for endometrial
cancer risk factors. Ovarian cancer risk is closely related to the total
frequency of ovulation. The risk of breast cancer can be explained by an
'estrogen-plus-progestogen hypothesis'. On the basis of this analysis an
hormonal contraceptive regimen has been developed consisting of a
gonadotropin-releasing hormone agonist (GnRHA) plus continuous low-dose
add-back estrogen and a short course of progestogen every fourth month.
The total dose of add-back estrogen is estimated to be approximately 38%
that in present-day low-dose combination-type oral contraceptives
(COCs). The total dose of progestogen is approximately 15% that in COCs.
This regimen prevents ovulation and should thus reduce ovarian cancer
risk. It also reduces the exposure of the endometrium to unopposed
estrogen, and the exposure of the breast to estrogen-plus-progestogen.
It is estimated that use of such a regimen for 10 years will only reduce
lifetime risk of endometrial cancer by one-sixth, but lifetime risk of
ovarian cancer is estimated to be reduced by two-thirds, and lifetime
risk of breast cancer is estimated to be reduced by one-half.
UI - 1415442
AU - Kaunitz AM
Oral contraceptives and gynecologic cancer: an update for the 1990s.
SO - Am J Obstet Gynecol 1992 Oct;167(4 Pt 2):1171-6
AD - University of Florida Health Science Center, Jacksonville 32209.
The most recent statistical evidence confirms a protective effect of
oral contraceptive use against ovarian and endometrial cancers. Studies
of the association between oral contraceptive use and cervical cancer
continue to be hampered by confounding factors; however, results suggest
that the overall risk of invasive cervical neoplasia is not increased.
Although the association between oral contraceptive use and breast
cancer remains controversial, existing data strongly suggest that
overall risk of breast cancer is not increased by the use of oral
contraceptives. In most candidates for oral contraceptive use, the
benefits greatly outweigh the risks.
UI - 1466924
AU - Wilkinson CE; Peters TJ; Harvey IM; Stott NC
Risk targeting in cervical screening: a new look at an old problem.
SO - Br J Gen Pract 1992 Oct;42(363):435-8
AD - Department of General Practice, University of Wales, College of
In the face of continuing debate about the level of effectiveness of the
United Kingdom cervical cytology screening programme in preventing
cervical cancer, more precise targeting of high risk groups might offer
a means of enhancing its efficiency. Broad risk targeting is already
practised by screening only sexually active women aged 20 to 65 years.
This paper describes a risk scoring system constructed from the
available literature and designed to be used by primary care health
professionals and patients. The system involves four independent risk
factors: educational level, current smoking habit, years of oral
contraceptive use and number of sexual partners. Since the objective is
simply to identify women at relatively high risk, inclusion of a factor
neither requires nor implies causality. The next steps are to study the
feasibility of putting the scale to practical use and to investigate its
predictive value in a prospective evaluation.
UI - 1345289
AU - Luukkainen T
[Health benefits of contraception]
SO - Duodecim 1992;108(23-24):2083-7
AD - Helsingin yliopiston laaketieteellisen kemian laitos, Helsinki, Finland.
UI - 8318416
AU - Twaddle S; McIlwaine G
Uptake of cervical screening.
SO - Br J Cancer 1993 Jul;68(1):213
UI - 7398868
AU - Anonymous
Combined pills may decrease endometrial cancer risk; sequentials may
SO - Fam Plann Perspect 1980 May-Jun;12(3):162
UI - 6263995
AU - Kanda K
[Studies on the viability of trophoblast after termination of various
kinds of pregnancies (author's transl)]
SO - Nippon Sanka Fujinka Gakkai Zasshi 1980 Oct;32(10):1575-82
Although normal value of hCG (LH level) does not necessarily indicate
eradication of viable trophoblast, its confirmation has been
demonstrated as a clinically useful guide for the probable prevention of
choriocarcinoma after hydatidiform mole by Takeuchi et al.
Choriocarcinoma preceded by other pregnancies than hydatidiform mole
which has the highest risk for choriocarcinoma has drawn more attention
than before in connection with the decrease of postmolar
choriocarcinoma. So that I have studied the regression rate of urinary
gonadotropin (hCG) after the termination of various kinds of
pregnancies. In 2,433 cases of induced abortion, 695 cases of
spontaneous abortion, 1,724 cases of term delivery and 43 cases of
hydatidiform mole, their urinary hCG were determined to the level of
physiological range of LH. The rate of hCG regression was in the order
of term delivery, spontaneous abortion, induced abortion and
hydatidiform mole. The younger was the gestational age of trophoblast,
the slower was the regression of hCG. At one month after the termination
of pregnancy, 80.1%, 11%, 0.3%, 8% and 4.1%, and at two month 55.8%,
1.6%, 0.5%, 4% and 0.5% for hydatidiform mole, induced abortion of less
than 12 week of gestation, spontaneous abortion of less than 12 week of
gestation, spontaneous abortion of between 13 and 20 week of gestation
respectively still showed abnormal hCG value. One percent of induced
abortion at 5 month, 4% of spontaneous abortion at 3 month, 0.3% of term
delivery at 4 month still maintained abnormal titer. No malignant
sequelae in patients under the investigation have ever been observed in
the follow up period between 3 and 8 years.
UI - 7339244
AU - King RJ; Lane G; Siddle N; Taylor RW; Townsend PT; Whitehead MI
Assessment of oestrogen and progestin effects on epithelium and stroma
from pre- and postmenopausal endometria.
SO - J Steroid Biochem 1981 Dec;15():175-81
UI - 7033575
AU - Hulka BS; Chambless LE; Kaufman DG; Fowler WC Jr; Greenberg BG
Protection against endometrial carcinoma by combination-product oral
SO - JAMA 1982 Jan 22-29;247(4):475-7
Seventy-nine patients with endometrial carcinoma were compared with 203
control subjects regarding their use of combination-product oral
contraceptives (OCs). Overall, 6.3% of patients and 15.3% of control
subjects had used these products. The risk of endometrial cancer for
users of OCs was less than half the risk for nonusers. Five years or
more of use reduced the risk to a third. Recent users were strongly
protected, whereas discontinuation resulted in risks returning to those
of nonusers. Furthermore, OCs with predominantly progestational effects
of intermediate formulations produced greater protection than those with
predominantly estrogens. This pattern of results is biologically
consistent with a protective effect of combination-product OCs against
UI - 7065059
AU - Mishell DR Jr
Noncontraceptive health benefits of oral steroidal contraceptives.
SO - Am J Obstet Gynecol 1982 Mar 15;142(6 Pt 2):809-16
Prospective and retrospective epidemiologic studies involving oral
contraceptives have been reviewed to determine the existence and extent
of their benefits other than prevention of pregnancy. There is less
menstrual blood loss, which reduces the risk of iron deficiency anemia
by about 50%. The incidence of menorrhagia, irregular menses, and
intermenstrual bleeding is also significantly reduced in users of oral
contraceptives. Studies have shown an approximate 50% reduction in risk
of endometrial cancer in oral contraceptive users, as well as a
significant reduction in various types of benign breast disease. Because
oral contraceptives inhibit ovulation, functional ovarian cysts are
nearly eliminated, and the incidence of dysmenorrhea and premenstrual
tension is significantly reduced. Oral contraceptives also protect women
from developing ovarian carcinoma, rheumatoid arthritis, and
salpingitis. From this review we conclude that the benefits of oral
contraceptives in young healthy women for far outweight their more
widely publicized, infrequent risks.
UI - 7045417
AU - Rosenberg L; Shapiro S; Slone D; Kaufman DW; Helmrich SP; Miettinen OS;
Stolley PD; Rosenshein NB; Schottenfeld D; Engle RL Jr
Epithelial ovarian cancer and combination oral contraceptives.
SO - JAMA 1982 Jun 18;247(23):3210-2
The risk of epithelial ovarian cancer in relation to the use of
combination oral contraceptives was evaluated in a case-control study of
women younger than 60 years. Combination oral contraceptives were used
by 35 (26%) of 136 cases and 187 (35%) of 539 controls. The relative
risk estimate for combination oral contraceptive use was 0.6 (95%
confidence interval, 0.4 to 0.9). The reduction in risk appeared to
persist for as long as ten years after use had ceased and to be greater
for longer durations of use, but these results were not statistically
significant. The findings were not explained by parity or by other
identified potential confounding factors. The results suggest that the
use of combination oral contraceptives protects against epithelial
UI - 7097914
AU - Evrard JR
Protection against endometrial carcinoma by combination-product oral
SO - JAMA 1982 Aug 13;248(6):647-8
UI - 7117506
AU - Ory HW
The noncontraceptive health benefits from oral contraceptive use.
SO - Fam Plann Perspect 1982 Jul-Aug;14(4):182-4
UI - 7145772
AU - Greenblatt RB; Gambrell RD Jr; Stoddard LD
The protective role of progesterone in the prevention of endometrial
SO - Pathol Res Pract 1982 Aug;174(3):297-318
An association between endometrial hyperplasia and corpus cancer has
long been suspected. Genetically predisposed women are at greater risk
of developing endometrial cancer if subjected to long uninterrupted
period of estrogen stimulation. Endometrial cancer need not be
inevitable if 14 day courses of an oral progestogen are continued for as
long as is necessary; in some women, however, the lesions will progress
and, therefore, should be carefully followed with repeated endometrial
biopsies. Epidemiological evidence suggests a true link between
unopposed estrogens and early, less invasive endometrial cancer, and
progestogens appear capable of protecting against the development of
cancer and hyperplasia, although complete protection has not yet been
achieved. The protective action of progestogens is supported by the fact
the none developed endometrial cancer in a series of 490 women of
reproductive age who received continuous estrogens by way of pellet
implants of 17 beta estradiol for conception control for 1--10 years.
Evidence for the protective action of progestogens in estrogen-treated
menopausal women was less solid than in non-menopausal women but was
nonetheless considerable. Our study of 1058 women, 45 years of age and
older, receiving continuous estrogens by way of 17 beta estradiol
pellets over a period varying from 1 to 21 years, revealed that the
incidence of cancer was not greater and was possibly less than that
expected in an untreated population of menopausal women.
UI - 3841044
AU - Hellberg D; Valentin J; Nilsson S
Long-term use of oral contraceptives and cervical neoplasia: an
association confounded by other risk factors?
SO - Contraception 1985 Oct;32(4):337-46
One-hundred-and-forty women with cervical intraepithelial neoplasia
(CIN) found during pregnancy were compared to 280 pregnant age-matched
controls. Information was obtained on obstetrical and gynecological
history, sexual behaviour, contraceptive use and smoking of the female
and of the male partner. Oral contraceptive use for 60 months or more
was significantly associated with CIN. This significance vanished when
the effect of confounding factors was controlled for in a log-linear
analysis. According to these results, long-term oral contraceptive use
does not seem to be a causal factor of CIN, but these women constitute a
high risk group due to sexual history and smoking habits and should thus
be referred for a regular cytological screening.
UI - 6762965
AU - Bettochi S; Restaino A; Lucisano F; Orlando E; Ferreri R; Ierardi GM;
Epidemiological factors and prophylaxis of ovarian tumors.
SO - Eur J Gynaecol Oncol 1982;3(3):192-205
UI - 3841750
AU - La Vecchia C
The epidemiology of cervical neoplasia.
SO - Biomed Pharmacother 1985;39(8):426-33
Controversial topics in the epidemiology of cervical neoplasia are
reviewed, in the light of data from studies conducted in Italy and
indications from the literature. The downward trends registered over the
last three decades in mortality from cervical cancer seem to be
levelling off in the younger age groups (below age 45). This may be
partly due to changes in sexual habits in younger women, but is
certainly attributable to deficiencies in cervical screening. Pap smear,
in fact, strongly reduces the risk of cervical neoplasia, the protection
(as suggested by data from a case control study), being long lasting
(over five years and perhaps around 10-15 years) for invasive cancers.
The results of the same case-control study indicate that, although women
with pre-invasive and invasive conditions seem to share several
unspecific indicators of sexual habits (i.e., total number of partners
and age at first intercourse), they appear to differ with regard to
clinical history of specific venereal disease. In fact, genital warts,
herpes genitalis and trichomoniasis were more frequent in cases of
intraepithelial neoplasia, but not of invasive cancer. The implications
of these findings, and of other controversial points in the epidemiology
of cervical neoplasia, such as oral contraceptives, cigarette smoking
and diet, are discussed with regard to indications from other
disciplines (chiefly molecular hybridization and stochastic models of
UI - 3855123
AU - Anonymous
Oral contraceptives come of age.
SO - Can Oper Room Nurs J 1985 May-Jun;3(3):44
UI - 3955285
AU - Drife J; Guillebaud J
Hormonal contraception and cancer.
SO - Br J Hosp Med 1986 Jan;35(1):25-9
The natural menstrual cycle can influence the development of some
cancers. Combined oral contraceptives, which replace normal hormonal
fluctuations with steadier levels of artificial sex hormones, appear to
protect against cancers of the endometrium and ovary, but their effect
on carcinomas of the breast and cervix remains uncertain.
UI - 3523849
AU - Fortney JA; Harper JM; Potts M
Oral contraceptives and life expectancy.
SO - Stud Fam Plann 1986 May-Jun;17(3):117-25
Life expectancy for women in the United States is 77.34 years; women who
take oral contraceptives (OCs) for five years before the age of 30 can
expect to live about four days longer. This is due primarily to
protection against ovarian and endometrial cancers. For women taking
pills for five years in their thirties there is a maximum loss of 18
days on the average that is attributable to OC use, and for women over
45 this rises to 80 days. The decreased life expectancy is due mainly to
the increased mortality from myocardial infarction and stroke. This is
substantially less than life lost due to use of a variety of other
substances, most notably tobacco.
UI - 3772914
AU - Connell EB
Minimizing the metabolic risks of oral contraceptives through patient
counseling and monitoring.
SO - J Reprod Med 1986 Sep;31(9 Suppl):934-8
Before selecting a method of contraception, it is necessary to obtain a
careful medical, family and personal history. In addition, a physical
examination and basic laboratory studies must be done. It is important
to properly counsel all patients who wish to use an oral contraceptive
(OC), particularly if they have one or more risk factors. This
counseling should include the rationale for using a low-dose,
low-potency OC, what side effects to look for and what the follow-up
schedule will be so that the patients are monitored adequately.
UI - 6888595
AU - Meuwissen JH
[The "other" advantages of the pill]
SO - Ned Tijdschr Geneeskd 1983 Jul 16;127(29):1294-6
UI - 6889241
AU - Lloyd G
Evaluating well-woman clinics.
SO - Practitioner 1983 May;227(1379):735-43
UI - 3631051
AU - Celentano DD; Klassen AC; Weisman CS; Rosenshein NB
The role of contraceptive use in cervical cancer: the Maryland Cervical
Cancer Case-Control Study.
SO - Am J Epidemiol 1987 Oct;126(4):592-604
Recent evidence on the importance of sexual history and sexually
transmissible agents in cervical cancer has been reported. Case-control
studies have frequently demonstrated increased risk of cervical cancer
for women using oral contraceptives, while laboratory results have shown
that vaginal spermicides inactivate various sexually transmissible
agents. To determine the role of contraceptive use in cervical cancer,
153 cases of Maryland women with invasive cervical cancer and age, race,
and residence-matched controls were interviewed in 1985, focusing on
sexual history, health care utilization patterns, screening history,
contraceptive use, and smoking. Overall, lifetime use of contraceptives
was protective of cervical cancer (odds ratio (OR) = 0.38, 95%
confidence interval (CI) = 0.2-0.7). Use of oral contraceptives (OR =
0.48), diaphragm (OR = 0.29), and vaginal spermicides (OR = 0.28) were
more frequent in controls than cases. After adjustment for behavioral
factors (age at first intercourse, smoking, gaps in Papanicolaou smear
testing, and obstetrician-gynecologist visits), use of vaginal
spermicides remained significant (OR = 0.30), although use of oral
contraceptives and barrier methods of contraception failed to remain
significant. The effectiveness of vaginal spermicides in preventing
cervical cancer may be due to their antiviral action.
UI - 6685843
AU - Colla G; Volante R; Visentin L; Pescarmona A
[Positive effects of oral contraceptives]
SO - Minerva Ginecol 1983 Jul-Aug;35(7-8):505-10
UI - 6150780
AU - Mills A
SO - Clin Obstet Gynaecol 1984 Dec;11(3):641-60
Barrier contraception is a safe, effective, reversible form of
contraception acceptable to many couples. The use of barrier
contraception may protect against carcinoma of the cervix and sexually
transmitted diseases. Distribution and education in the use of barrier
contraception does not always require medical supervision. This must
make it an attractive form of contraception for agencies supporting
family planning programmes in developing countries. The only marketed
recent advance in barrier contraception is the collatex sponge.
Effectiveness rates range between 9 and 27 pregnancies per 100
woman-years. This is unlikely to make it the first choice of
contraception for couples who would find an unintended pregnancy a
severe problem, but the sponge will be acceptable to couples who are
simply trying to delay a pregnancy. The new surge of interest in barrier
contraception could lead to safer more effective forms of contraception
being made available to women without medical supervision. This would
have many advantages, but could also detract from the ability of family
planning clinics to play an important role in preventative medicine for
UI - 2541323
AU - McMichael AJ; Hiller JE
Pills, partners and preventive prospects: in-situ cancer of the cervix.
SO - Med J Aust 1989 Feb 6;150(3):114-6
AD - Department of Community Medicine, The University of Adelaide.
UI - 2788456
AU - Villard-Mackintosh L; Vessey MP; Jones L
The effects of oral contraceptives and parity on ovarian cancer trends
in women under 55 years of age.
SO - Br J Obstet Gynaecol 1989 Jul;96(7):783-8
AD - Department of Community Medicine and General Practice, University of
Oxford, Radcliffe Infirmary.
Mortality from epithelial ovarian cancer is falling in women under 55
years of age in England and Wales. The decline does not appear to be a
treatment effect nor to be attributable to changes in the rate of
oophorectomy. Case-control studies have shown that high parity and oral
contraceptive use are protective against the disease. We suggest that
the decrease in mortality is compatible in timing and magnitude with
exposure to oral contraceptives. No obvious effect on mortality
attributable to parity was apparent in this analysis. Oral
contraceptives may prove to be a widely acceptable means of preventing
ovarian cancer, providing they do not increase breast cancer risk.
UI - 3109632
AU - Kitchener HC; Burnett RA; Wilson ES; Cordiner JW
Colposcopy in a family planning clinic: a future model?
SO - Br Med J (Clin Res Ed) 1987 May 23;294(6583):1313-5
The first year's experience of a satellite colposcopy clinic in the
Glasgow Family Planning Centre was analysed. Establishment of the clinic
was supervised by an experienced member of the colposcopy team at the
department of gynaecology, Western Infirmary, Glasgow, who trained one
of the family planning centre's staff. Close links were thus maintained
with the hospital clinic to which patients were referred for treatment.
The policy at the new colposcopy clinic was to study prospectively all
women in the hospital catchment area whose cervical smears were reported
as abnormal. In 58 of 162 such patients there was at least moderate
dyskaryosis and the cytologist's recommendation had been referral for
colposcopy. In 104 cases the changes were either atypia alone or mild
dyskaryosis and a repeat smear was recommended within three to 12
months; 18 of these patients had grade II or III cervical
intraepithelial neoplasia on biopsy, and relying on repeat smears would
have resulted in an 11.7% false negative rate. If an a