What is the risk of gynaecological cancers in women using HRT or OCP?In women under hormonal replacement therapy or oral contraceptive pill, I am wondering what could be the risk of ovarian, uterine, vaginal and vulva carcinoma aside from well known breast cancer.
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- Answered 29 Sep 2019 Conflict of interest declaration: None What is the risk of gynaecological cancers in women using HRT or OCP? In women under hormonal replacement therapy or oral contraceptive pill, I am wondering what could be the risk of ovarian, uterine, vaginal and vulva carcinoma aside from well known breast cancer. A 2016 BJGP article appears to be a good review relating to HRT . Amongst other things it highlights the complexity of this area as there are many different types of HRT, any underlying dieases and also the timing of starting/stopping may play a factor. Cancer Research UK has a page “Does hormone replacement therapy increase cancer risk?”  which reports: “Yes, evidence shows that hormone replacement therapy (HRT) can increase risk of breast, ovarian and endometrial (womb) cancers” With regard oral contraceptive pills the 2017 Society of Obstetricians and Gynaecologists (Canada) reported : “Combined oral contraceptive pills are associated with a number of non-contraceptive benefits, including but not limited to decreased menstrual bleeding, decreased acne, fewer endometriosis-related symptoms, and a decreased risk of ovarian and endometrial cancers (II-2).” And “Current epidemiological studies suggest that there is no increase in the risk of breast cancer or breast cancer mortality in women who have used combined oral contraceptive pills (COCs) compared with non-users (II-2). There may be a slight increase in breast cancer in current and/or recent COC users (II-2). The use of COCs in BRCA1/2 carriers is controversial but appears to be associated with a decreased risk of ovarian cancer and no increase in the risk of breast cancer (II-2). 7.Combined oral contraceptive pills (COCs) are associated with a decreased risk of ovarian, endometrial, and colorectal cancers (II-2). A possible association has been shown between COC use and risk of cervical cancer (II-2), but causation has not been demonstrated.” Cancer Research UK also covers this topic “Does the contraceptive pill increase cancer risk?”  which states: “Yes, the contraceptive (or birth control) pill can slightly increase the risk of breast and cervical cancer But it can decrease the risk of some other cancer types” Finally, you may want to read the 2018 review “Oral Contraceptives and Cancer Risk” published by the National Cancer Institute . This states: “Overall, however, 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” References 1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198659/ 2) https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/hormones-and-cancer/does-hormone-replacement-therapy-increase-cancer-risk 3) https://www.jogc.com/article/S1701-2163(16)39786-9/abstract 4) https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/hormones-and-cancer/does-the-contraceptive-pill-increase-cancer-risk 5) https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/oral-contraceptives-fact-sheet