1. Women who used oral contraceptive pills (OCPs) were at a significantly lower risk of developing ovarian cancer than women who never used OCPs.
2. Reduction in ovarian cancer risk was OCP duration-dependent.
Evidence Rating Level: 2 (Good)
Study Rundown: This systematic review and meta-analysis identified a significant duration-dependent reduction in ovarian cancer incidence in women with a history of OCP use. This review adds to the existing literature base suggesting OCP use may be protective for ovarian cancer. This study is the first meta-analysis assessing the relationship between OCP use and ovarian cancer incidence, but findings are somewhat limited by a lack of randomized controlled trials. Prospective studies might better characterize the degree of ovarian cancer risk reduction affected by OCP use while also incorporating assessment of the risks of long-term OCP use.
Study Author, Dr. Laura J. Havrilesky, MD, talks to 2 Minute Medicine: Duke University School of Medicine, Department of Obstetrics and Gynecology
“This systematic review and meta-analysis reinforces the long recognized association between oral contraceptive (OC) use and a reduction in ovarian cancer incidence. While not providing definitive prospective evidence for the use of OCs solely for ovarian cancer prophylaxis, it does reinforce one potential medical benefit of OCs that should be discussed in addition to consideration of the established risks of this method of contraception.”
In-Depth [systematic review and meta-analysis]: This systematic review included controlled studies evaluating the incidence of ovarian cancer in women with and without exposure to oral contraceptive pills (OCPs). Two investigators independently reviewed articles for inclusion or exclusion. Random-effects meta-analyses were preformed examining the relationship between ever use of OCPs and duration of OCP use and the primary outcome, ovarian cancer incidence.
Twenty-four case-control and cohort studies met inclusion criteria and were included in the first meta-analysis, which found that women who had ever used OCP’s were 27% less likely to develop ovarian cancer compared to women who never used OCP’s (OR: 0.73, 95% CI: 0.66-0.81). Lifetime reduction in ovarian cancer attributable to OCPs was 0.54% such that the number needed to treat was 185 women (assuming an average of 5 years of use). Fifteen case-control and cohort studies were included in the second meta-analysis, which found that compared to never users, women who used OCPs for 1-12, 13-60, 61-120, and >120 months respectively had ORs of 0.91 (p=0.250), 0.77 (p=0.001), 0.65 (p<0.001), and 0.43 (p<0.001), demonstrating a dose-response relationship.
By Maren Shapiro and Leah Hawkins, MD, MPH
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