Risk of invasive cancer of the cervix in relation to the use of injectable progestogen contraceptives and combined estrogen/progestogen oral contraceptives (South Africa)

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dc.contributor.authorShapiro S.
dc.contributor.authorRosenberg L.
dc.contributor.authorHoffman M.
dc.contributor.authorKelly J.P.
dc.contributor.authorCooper D.D.
dc.contributor.authorCarrara H.
dc.contributor.authorDenny L.E.
dc.contributor.authorDu Toit G.
dc.contributor.authorAllan B.R.
dc.contributor.authorStander I.A.
dc.contributor.authorWilliamson A.-L.
dc.date.accessioned2011-05-15T16:15:51Z
dc.date.available2011-05-15T16:15:51Z
dc.date.issued2003
dc.description.abstractBackground: Cervical cancer is caused by specific types of the human papilloma virus (HPV), but not all infected women develop cancer. It has been hypothesized that hormonal contraceptives may potentiate the oncogenicity of HPV infection. Methods: In a case-control study of colored and black women in the Western Cape Province, South Africa, 524 incident cases of clinically evident invasive cervical cancer (stages 1b-1V) were compared with 1541 controls, and with a subgroup of 254 HPV-positive controls. Findings: For injectable progestogen contraceptives (95% of which were depot medroxyprogesterone acetate) the overall relative risk, adjusted for confounding, was 1.0 (95% confidence interval 0.8-1.3); for combined estrogen/progestogen oral contraceptives the corresponding estimate was 0.8 (0.7-1.1). When the data were divided into categories of duration of use extending to ≥15 years, or according to age, ethnic group, or recency of use, there was no consistent evidence of an increased risk. The findings were unchanged when the cases were compared with the HPV-positive controls. Interpretation: The present findings suggest that neither injectable progestogen-only nor combined estrogen/progestogen oral contraceptives increase the risk of clinically evident invasive cancer of the cervix.
dc.description.versionArticle
dc.identifier.citationCancer Causes and Control
dc.identifier.citation14
dc.identifier.citation5
dc.identifier.issn09575243
dc.identifier.other10.1023/A:1024910808307
dc.identifier.urihttp://hdl.handle.net/10019.1/13521
dc.subjectestrogen
dc.subjectgestagen
dc.subjectmedroxyprogesterone acetate
dc.subjectoral contraceptive agent
dc.subjectadult
dc.subjectarticle
dc.subjectcancer invasion
dc.subjectcancer risk
dc.subjectcancer staging
dc.subjectcarcinogenicity
dc.subjectcontrolled study
dc.subjectdrug use
dc.subjectethnic group
dc.subjectfemale
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectnegro
dc.subjectpriority journal
dc.subjectSouth Africa
dc.subjectuterine cervix cancer
dc.subjectWart virus
dc.subjectAdult
dc.subjectCase-Control Studies
dc.subjectContraceptives, Oral, Hormonal
dc.subjectEstrogens
dc.subjectFemale
dc.subjectHumans
dc.subjectInjections
dc.subjectMiddle Aged
dc.subjectPapillomavirus Infections
dc.subjectProgestins
dc.subjectRisk Assessment
dc.subjectRisk Factors
dc.subjectSouth Africa
dc.subjectUterine Cervical Neoplasms
dc.titleRisk of invasive cancer of the cervix in relation to the use of injectable progestogen contraceptives and combined estrogen/progestogen oral contraceptives (South Africa)
dc.typeArticle
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