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Tuesday, 26 March, 2002, 11:50 GMT Pill 'could boost cervical cancer risk'  Scientists use smear tests to check for cervical cancer
Long-term use of the contraceptive pill could increase the risk of developing cervical cancer in women with a sexually transmitted infection, researchers suggest. Women who are positive for the STI human papillomavirus (HPV) could be at up to three times greater risk of developing cancer if they have used the Pill for five years or longer. A four-fold increased risk was found for HPV-positive women who had taken the Pill for more than 10 years. But there is no evidence that long-term Pill use increases the risk of cervical cancer in women who do not have HPV. The virus is the main cause of cervical cancer, which killed around 1,250 UK women in 2000. An international panel of experts has looked at Pill use and HPV infection rates. In a paper published by The Lancet, they conclude long-term use of the Pill could be a contributory risk factor to developing cervical cancer in women with HPV.
They said the researchers had not proved that the Pill causes cervical cancer. And they said regular cervical screening would pick up signs of the disease early. 'Step in the process' Data for almost 1,900 women from studies carried out carried out in Thailand, the Philippines, Morocco, Brazil, Peru, Paraguay, Columbia and Spain was examined by scientists from the International Agency for Research on Cancer. The risk of cervical cancer ranges from 1% in developed countries to 5% in developing countries. Silvia Franceschi who led the study: "We think that our results lend support to the existence of an association between oral contraceptives and HPV. "They could help women who have persistent HPV infection to balance the benefits (prevention of pregnancy and cancers of the ovary and uterus) and harms of long-term oral contraceptive use, and suggest that long-term users of oral contraceptives should be included in cervical screening programmes." In a separate study, the IARC also found high numbers of pregnancies increases the risk of cervical cancer amongst HPV-positive women. David Skegg from the University of Otago, New Zealand, writing in a commentary in the Lancet, added: "Any causal relation between long-term oral contraception and cervical cancer would be most important in the developing world, where cervical cancer is common and few women have access to high-quality cytological screening. "From a public-health viewpoint, a key question is the extent to which effects persist after women stop taking oral contraceptives. "For nearly two decades, concerns about oral contraceptives and neoplasia were focused mainly on breast cancer-with the eventual outcome being reassuring. Ironically the relation with cervical cancer may turn out to be more important." He backed World Health Organization commissioned work to evaluate all the relevant data. 'No proof' Commenting on the findings looking at use of the Pill, HPV and cervical cancer, a spokeswoman for the Family Planning Association said: "The overall likelihood of getting cervical cancer in the UK is low whether you use the Pill for a long time of not." Dr Anne Szarewski, clinical consultant for Cancer Research UK, told BBC News Online: "This is certainly a very interesting study, but they have not actually proved that the Pill causes cervical cancer. "They have just shown that if you are HPV positive and take the Pill, you are at greater risk." Dr Szarewski said the most important thing for women in the UK to remember was that cervical screening would pick up any problems. She added that women should not be deterred from taking the Pill: "You have to balance this possible risk from the Pill against many known benefits, such as protection against ovarian and endometrial cancer." Women can reduce their risk of contracting HPV and other STIs by also using barrier methods of contraception. |
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