Under Supervision of

Dr. Fatima Al Faisal

Overview
 The most common methods of
contraception in Egypt include
OCPs, IUDs and birth control
Implants

 this presentation aims to

analyse the link between usage
of OCPs and the incidence of
the following neoplasias :
o Breast
o Cervical
o Endometrial
o Ovarian
Types Of OCPs

 There are 2 types Progesterone only and

Combined

 which could be:

1) Monophasic
2) Biphasic
3) Triphasic
 Benefits

 The birth control pill is a safe, simple, and

convenient way to prevent pregnancy

 The combination pill can also reduce or help

prevent:
• Osteoporosis
• cysts in breasts and ovaries
• endometrial and ovarian cancers
• serious infections in ovaries, fallopian tubes, and
uterus
• iron deficiency (anemia)
 Side Effects; most usually go away after 2 or 3
months. Many people use the pill with no problems at
all.

 Some of the side effects are:

• Nausea
• weight gain
• Melasma
• cervical extrophia and leukorrhea
• Hypermenorrhea, spotting and breakthrough
bleeding
• galactorrhea and pituitary tumors
• endometrial cancer, and hepatic effects
• Fetal exposure has been reported to result in
increased risk for the heart and neural tube defects
Epidemiology
 Nearly all the research between oral contraceptives
and cancer risk comes from observational studies

 Data from these studies cannot definitively establish

that an exposure in this case, oral contraceptives
causes (or prevents) cancer

 Overall, these studies have provided consistent

evidence that the risks
of breast and cervical cancers are increased in
women who use oral contraceptives, whereas the
risks of endometrial, ovarian,
and colorectal cancers are reduced
Breast Cancer
 Expresses receptors for both
estrogen and progesterone,
thus increasing its incidence

 Women who were using or

are still using OCPs had a
20% increase risk of breast
cancer comparing to those
who have never used it or
stopped using it for several
years
 Moreover, the increased risk varied from
0 to 60%, increasing in those who were
taking a certain type of OCPs
(triphasic) dose of hormones is
changed in the course of the female
monthly cycle in three stages

 Family history of breast cancer and the

use of OCPs? Not enough supported
data

 Therefore, the most important risk factor

seems to be the long duration of OCPs
usage at a young age, as hormones act
on a less differentiated tissue
Cervical Cancer
 The use of OCPs increases the
cervical cells susceptibility to
HPV infections, therefore
increasing the cancer risk, this
was seen in women with Pre-
existing risk factors such as;
smoking, high parity, exposure of
STDs

 Its been addressed by one study

that the risk of cervical cancer
doubles with 10 years of OCPs
usage.
Ovarian Cancer
 Women who have used OCPs have
consistently shown lower incidences of
ovarian cancer, when compared with women
who've never used OCPs by 30% to 50%

 This protection positively correlates with

duration of use and lasted up to 30 years
after stopping oral contraceptives

 This decreased risk was also apparent in

women carrying harmful mutations in
BRCA1/BRCA2 genes.

 The mechanism of lower incidence is thought

to be due to the reduction in ovulations per
lifetime reducing the risk of cancer
Endometrial Cancer
 Like with ovarian cancer women who have
used OCPs showed risk reduction of at least
30% as opposed to women who haven’t

 Again the risk reduction increased with

duration of use and the effects persisted
years after stopping OCPs

 The risk reduction was especially evident in

predisposed women eg,. smokers, obese,
sedentary lifestyle

 The lowered incidence has been attributed to

suppressed endometrial proliferation
Conclusion
 The benefits of using OCPs with regards to
decreased risk of endometrial, ovarian,
colorectal cancers largely offsets the risks
being increased incidence of breast and
cervical cancer

 Current research doesn't definitively show

that OCPs are the exposure responsible for
the altered incidence in the aforementioned
cancers, further experimental studies
would be necessary
References
 Mørch LS, Skovlund CW, Hannaford PC, et al. Contemporary
hormonal contraception and therisk of breast cancer. New England
Journal of Medicine 2017; 377(23):2228-2239.
 Beaber EF, Buist DS, Barlow WE, et al. Recent oral contraceptive
use by formulation and breast cancer risk among women 20 to 49
years of age. Cancer Research 2014; 74(15):4078-4089.

 CGHFBCBreast cancer and hormonal contraceptives: collaborative

reanalysis of individual data on 53 297 women with breast cancer
and 100 239 women without breast cancer from 54 epidemiological
studies. Collaborative Group on Hormonal Factors in Breast
Cancer, Lancet , 1996, vol. 347 (pg. 1713-
1727)https://doi.org/10.1016/S0140-6736(96)90806-5
 Smith JS, Green J, Berrington de Gonzalez A, et al. Cervical cancer and
use of hormonalcontraceptives: a systematic review. Lancet2003;
361(9364):1159-1167
 Iversen L, Sivasubramaniam S, Lee AJ, Fielding S, Hannaford PC. Lifetime
cancer risk and combined oral contraceptives: The Royal College of
General Practitioners' Oral Contraception Study. American Journal of
Obstetrics and Gynecology 2017; 216(6):580.e1-580.e9.
 https://monographs.iarc.fr/wp-content/uploads/2018/06/mono100A-19.pdf
 https://jamanetwork.com/journals/jamaoncology/fullarticle/2669779?utm_ca
mpaign=articlePDF&utm_medium=articlePDFlink&utm_source=articlePDF
&utm_content=jamaoncol.2017.4
 https://jamanetwork.com/journals/jamaoncology/fullarticle/2669779?utm_ca
mpaign=articlePDF&utm_medium=articlePDFlink&utm_source=articlePDF
&utm_content=jamaoncol.2017.4942

 https://egypt.unfpa.org/en/node/22543
Prof. Dr. Mamdouh Shiba Unit
• Mohamed Khaled
• Mohamed Saad
• Fatima Khalifa
• Karim Ahmed
• Ibrahim Magdy
• Mohamed Rojan
• Rana Ragy
• Mohamed Aboul Fetouh
• Mostafa Ahmed
• Ahmed Saber
• Sara Albarawi
Thank You