CONTENTS

          Chapters
  1. Background
  2. Oral Contraceptive Use
  3. Benefits of Oral Contraceptives
  4. Health Risks of Oral Contraceptives
  5. Unresolved Health Issues
  6. Emergency Contraceptive Pills
  7. A Practical Guide to ECP

HIGHLIGHTS

Population Reports is published by the Population Information Program, Center for Communication Programs, The Johns Hopkins School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202-4012, USA


Volume XXVIII, Number 1
Spring, 2000

Series A, Number 9
Oral Contraceptives

Liver Cancer

A number of case-control studies in developed countries have detected increased risks of a rare liver cancer, hepatocellular carcinoma, in OC users (139, 196, 254, 324, 342, 455, 548). These studies reported risks among OC users about 2 to 20 times greater than risks among nonusers. The largest of these studies found that women using OCs for eight years or more were four times more likely to develop this liver cancer than nonusers (324). In contrast, a recent study in six European countries (191) and a study of South African women (240) found no increased risk of hepatocellular carcinoma among short-term or long-term users.

A number of case-control studies in developed countries have detected increased risks of a rare liver cancer, hepatocellular carcinoma, in OC users (139, 196, 254, 324, 342, 455, 548). These studies reported risks among OC users about 2 to 20 times greater than risks among nonusers. The largest of these studies found that women using OCs for eight years or more were four times more likely to develop this liver cancer than nonusers (324). In contrast, a recent study in six European countries (191) and a study of South African women (240) found no increased risk of hepatocellular carcinoma among short-term or long-term users.

Canadian poster urging pill users to use condoms.
City of Toronto, Department of Public Health
For protection against sexually transmitted diseases (STDs), including HIV, the virus that causes AIDS, latex condoms are the best method and can be used along with OCs. This Canadian poster urges pill users to use condoms to prevent AIDS and STDs.
Liver cancer is quite rare, but it is usually fatal within a year of diagnosis. Therefore, if OCs significantly increased the risk of liver cancer, both incidence of the disease and mortality from it should have risen noticeably since the 1960s, when OCs were introduced. A recent study, however, found no evidence of increased incidence or mortality either in the US or in Sweden, two countries where OCs have been used extensively since the 1960s. Instead, the study found a gradual increase in incidence of liver cancer and resulting mortality in Japan, where OCs are seldom used (501).

Despite some lingering uncertainties, the benefits of oral contraceptives far outweigh the risks for the vast majority of women. Continuing research has made it possible to identify more clearly the few women who face substantial risks and should choose another method of contraception. Forty years after their introduction, OCs remain popular for their convenience, effectiveness, and safety.


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