Williams William V, Mitchell Louise A, Carlson S Kathleen, Raviele Kathleen M
BriaCell Therapeutics Corporation, West Vancouver, British Columbia, Canada.
University of Pennsylvania, Philadelphia, PA, USA.
Linacre Q. 2018 Nov;85(4):412-452. doi: 10.1177/0024363918811637. Epub 2019 Jan 3.
Combined estrogen-progestogen contraceptives (oral contraceptives or OCs) and progestogen-only contraceptives (POCs) are synthetic steroids that bind to steroid hormone receptors, which are widespread throughout the body. They have a profound effect on cellular physiology. Combined OCs have been classified by the International Agency for Research on Cancer (IARC) as Group 1 carcinogens, but their findings have not been updated recently. In order to update the information and better understand the impact that OCs and POCs have on the risk of development of cancers, a comprehensive literature search was undertaken, focusing on more recently published papers. In agreement with the IARC, the recent literature confirms an increased risk of breast cancer and cervical cancer with the use of OCs. The recent literature also confirms the IARC conclusion that OCs decrease the risk of ovarian and endometrial cancers. However, there is little support from recent studies for the IARC conclusion that OCs decrease the risk of colorectal cancer or increase the risk of liver cancer. For liver cancer, this may be due to the recent studies having been performed in areas where hepatitis is endemic. In one large observational study, POCs also appear to increase the overall risk of developing cancer. OCs and POCs appear to increase the overall risk of cancer when carefully performed studies with the least intrinsic bias are considered.
OCs have been classified as cancer-causing agents, especially leading to increases in breast cancer and cervical cancer. A review of the recent scientific literature was performed to see whether this still appears to be the case. The recent literature supports the cancer-causing role of OCs especially for breast cancer and cervical cancer. Studies also indicate that progesterone-only contraceptives (such as implants and vaginal rings) also can cause cancer. This is especially true for breast cancer and cervical cancer.
复方雌激素 - 孕激素避孕药（口服避孕药或OCs）和仅含孕激素的避孕药（POCs）是与类固醇激素受体结合的合成类固醇，这些受体遍布全身。它们对细胞生理学有深远影响。国际癌症研究机构（IARC）已将复方OCs归类为1类致癌物，但其研究结果最近尚未更新。为了更新信息并更好地了解OCs和POCs对癌症发生风险的影响，进行了全面的文献检索，重点关注最近发表的论文。与IARC一致，近期文献证实使用OCs会增加患乳腺癌和宫颈癌的风险。近期文献还证实了IARC的结论，即OCs可降低卵巢癌和子宫内膜癌的风险。然而，近期研究几乎没有支持IARC关于OCs可降低结直肠癌风险或增加肝癌风险的结论。对于肝癌，这可能是由于近期研究是在肝炎流行地区进行的。在一项大型观察性研究中，POCs似乎也会增加患癌的总体风险。当考虑进行了最少内在偏倚的精心研究时，OCs和POCs似乎会增加患癌的总体风险。
OCs已被归类为致癌物质，尤其是会导致乳腺癌和宫颈癌的发病率增加。对近期科学文献进行了综述，以查看情况是否仍然如此。近期文献支持OCs的致癌作用，尤其是对乳腺癌和宫颈癌。研究还表明，仅含孕激素的避孕药（如植入剂和阴道环）也会致癌。对于乳腺癌和宫颈癌尤其如此。
