Oral Contraceptive Pills as Primary Prevention for Ovarian Cancer: A Systematic Review and Meta-analysis

  title={Oral Contraceptive Pills as Primary Prevention for Ovarian Cancer: A Systematic Review and Meta-analysis},
  author={Laura J. Havrilesky and Patricia G. Moorman and William J. Lowery and Jennifer M Gierisch and Remy R Coeytaux and Rachel Peragallo Urrutia and Michaela A. Dinan and Amanda J. McBroom and Vic Hasselblad and Gillian D. Sanders and Evan R. Myers},
  journal={Obstetrics \& Gynecology},
OBJECTIVE: To estimate the overall reduction in ovarian cancer risk associated with the use of oral contraceptive pills (OCPs) and whether reduction in risk is affected by specifics of OCP use, such as formulation or duration of use. DATA SOURCES: We searched PubMed, Embase, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov for studies published from January 1990 to June 2012, with primary analysis of studies published since January 2000. METHODS OF STUDY SELECTION: We… 
Oral contraceptive pills as primary prevention for ovarian cancer: a systematic review and meta-analysis.
The authors agree with the authors that oral contraceptive pill use can decrease the risk of developing ovarian cancer, but they believe that further studies still are required.
Intrauterine Device Use and Ovarian Cancer Risk: A Systematic Review and Meta-analysis.
Intrauterine device use is associated with a reduced incidence of ovarian cancer based on a review of existing retrospective data, and prospective investigation into the role of IUDs in ovarian cancer prevention is limited.
Menopausal Hormone Replacement Therapy and the Risk of Ovarian Cancer: A Meta-Analysis
It is suggested that menopausal HRT may increase the risk of ovarian cancer, especially for serous and endometrioid tumors.
Screening and Prevention of Ovarian Cancer
Clinicians are recommended to encourage high-risk women who delay or decline risk- reducing surgery to discuss risk-reducing pharmacologic options in order to prevent ovarian cancer progression without elevation of breast cancer risk.
What are the mechanisms of action of the different contraceptive methods to reduce the risk of ovarian cancer?
Combined hormonal contraceptive use is an effective method of chemoprevention for OvCa in the general population and in women with genetic disorders and salpingectomy, better than tubal ligation, should be offered for ovarian/tubal/peritoneal cancer prevention.
The Chemoprevention of Ovarian Cancer: the Need and the Options
The role of risk assessment in the design of chemoprevention strategies for OvCa is discussed, candidate agents are described, and future directions in this field are assessed.
Beyond the pill: contraception and the prevention of hereditary ovarian cancer
There has been a considerable shift in patterns of contraceptive use and the increase in the uptake of non-oral, long-acting, reversible contraception has corresponded to a decline in oral contraceptive pill use, and the impact of these changes on the risk of developing ovarian cancer is not known.
Association of Hormonal Contraceptive Use With Adverse Health Outcomes
No associations with adverse outcomes, including cardiovascular and cancer risk, were supported by high-quality evidence, but the association between the use of a levonorgestrel-releasing intrauterine system and reductions in endometrial polyps associated with tamoxifen use was graded as having high- quality evidence.
Endocrine interventions in women with BRCA1/2 mutations
Oral contraceptives seem to slightly increase the breast cancer risk of BRCA1/2 mutation carriers, but they also have a tremendous protective effect against ovarian cancer.


Oral contraceptive use for the primary prevention of ovarian cancer.
There is insufficient evidence to recommend for or against the use of OCs solely for the primary prevention of ovarian cancer, and the harm/benefit ratio was much more favorable when protection against endometrial and colorectal cancers was added.
Long‐term effects of oral contraceptives on ovarian cancer risk
The present analysis indicates that, after taking into account duration of OC use, the OC protection from ovarian cancer persists for a long time after stopping use.
Pooled analysis of 3 european case‐control studies of epithelial ovarian cancer: III. Oral contraceptive use
The relationship between use of oral contraceptives and other contraceptive methods and the risk of ovarian cancer was examined in a combined analysis of 3 hospital‐based case‐control studies in Italy, the United Kingdom, and Greece, suggesting that the protection persists for 15 years or more after cessation of use and may be larger for use at younger age.
Prospective study of oral contraceptives and hypertension among women in the United States.
Current users of oral contraceptives had a significant, moderately increased risk of hypertension, but among this group, only 41.5 cases per 10 000 person-years could be attributed to oral contraceptive use.
Effect of screening on ovarian cancer mortality: the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Randomized Controlled Trial.
Among women in the general US population, simultaneous screening with CA-125 and transvaginal ultrasound compared with usual care did not reduce ovarian cancer mortality.
Screening for Ovarian Cancer: U.S. Preventive Services Task Force Reaffirmation Recommendation Statement
  • V. Moyer
  • Medicine
    Annals of Internal Medicine
  • 2012
This recommendation applies to asymptomatic women and does not apply to women with known genetic mutations that increase their risk for ovarian cancer (for example, BRCA mutations).
The efficacy of transvaginal sonographic screening in asymptomatic women at risk for ovarian cancer.
TVS screening does not appear to be effective in detecting ovarian cancer in which ovarian volume is normal, and when performed annually, is associated with a decreases in stage at detection and a decrease in case-specific ovarian cancer mortality.