Veljković Milena, Veljković Slavimir
Dom zdravlja Nis, Nis.
Med Pregl. 2010 Sep-Oct;63(9-10):657-61. doi: 10.2298/mpns1010657v.
Oral contraceptives, mainly combined monophasic pills, are widely used by young women who expect their physicians to prescribe them safe drugs which will not harm their health and which will simplify their life. Numerous epidemiologic studies have been performed to determine the relation between oral contraceptive use and the development of neoplasms.
An increased incidence of breast cancer has occurred simultaneously with the growing use of oral contraceptives. The possibility of a link between the oral contraceptive use and breast cancer has led to intensive research, but studies have provided inconsistent results causing confusion among clinicians. It was noticed that the risk of breast cancer was slightly elevated in current and recent young oral contraceptives users. That finding could be influenced by a detection bias or could be due to the biologic effect of the pills. The absolute number of additional breast cancer cases will be very small because of low baseline incidence of the disease in young women. Oral contraceptives probably promote growth of the already existing cancer, they are probably promoters not initiators of breast cancer. The available data do not provide a conclusive answer that is needed.
Numerous factors may influence the development of cervical cancer. The evidence suggests that current and recent oral contraceptive users have an increased risk of cervical cancer which decline after discontinuation of the application of medication. Oral contraceptives might increase the biological vulnerability of the cervix. Cervical cancer develops slowly over a long time period and can be effectivelv prevented by periodic cervical screening. Fortunately, oral contraceptives do not mask abnormal cervical citology. Conclusions regarding invasive cervical cancer and oral contraceptive use are not definitive but if there is any increased risk, it is low.
In oral contraceptive users the endometrium is almost under the influence of progestin component which suppresses endometrial mitotic activity and its proliferation. Most epidemiologic studies show that oral contraceptives reduce the risk of endometrial cancer and that this protective effect exists many years after the discontinuation of medication.
It has been long known that the oral contraceptive use causes protective anovulation and reduces the risk of ovarian cancer. This powerful reduction is the best demonstrated major benefit of oral contraception. This protection is especially observed in nulliparous and seems to persist for many years after the discontinuation of medication.
口服避孕药，主要是复方单相片，被年轻女性广泛使用，她们期望医生为其开具不会损害健康且能简化生活的安全药物。已经进行了大量流行病学研究以确定口服避孕药的使用与肿瘤发生之间的关系。
乳腺癌发病率的增加与口服避孕药使用的增加同时出现。口服避孕药的使用与乳腺癌之间存在关联的可能性引发了深入研究，但研究结果并不一致，这给临床医生带来了困惑。人们注意到，当前及近期使用口服避孕药的年轻女性患乳腺癌的风险略有升高。这一发现可能受到检测偏倚的影响，也可能是由于药物的生物学效应。由于年轻女性中该疾病的基线发病率较低，额外乳腺癌病例的绝对数量将非常少。口服避孕药可能促进已存在癌症的生长，它们可能是乳腺癌的促进因素而非启动因素。现有数据并未提供所需的确切答案。
许多因素可能影响宫颈癌的发生。证据表明，当前及近期使用口服避孕药的女性患宫颈癌的风险增加，停药后风险会下降。口服避孕药可能会增加子宫颈的生物学易感性。宫颈癌是在很长一段时间内缓慢发展的，通过定期宫颈筛查可以有效预防。幸运的是，口服避孕药不会掩盖宫颈细胞学异常。关于浸润性宫颈癌与口服避孕药使用的结论并不明确，但如果存在任何增加的风险，也是很低的。
在口服避孕药使用者中，子宫内膜几乎受到孕激素成分的影响，该成分会抑制子宫内膜的有丝分裂活性及其增殖。大多数流行病学研究表明，口服避孕药可降低子宫内膜癌的风险，且这种保护作用在停药多年后依然存在。
长期以来已知口服避孕药可导致保护性无排卵并降低卵巢癌风险。这种显著的降低是口服避孕药最明显的主要益处。这种保护作用在未生育女性中尤为明显，并且在停药后似乎会持续多年。
