From the Guidelines
No, combined oral contraceptive pills (COCPs) have not just been increased to the highest level of carcinogen. The International Agency for Research on Cancer (IARC) classifies COCPs as Group 1 carcinogens, indicating sufficient evidence that they can cause cancer in humans, specifically a small increased risk of breast cancer and cervical cancer 1. However, this classification is not new and has been in place for many years. It's essential to understand that COCPs also have protective effects against other cancers, including significant reductions in ovarian and endometrial cancer risk 1. The overall cancer risk-benefit profile of COCPs is generally considered favorable for most women, and the absolute increase in cancer risk for an individual woman is very small. Healthcare providers weigh these risks against the benefits of effective contraception and other non-contraceptive benefits when prescribing these medications. Women with specific risk factors, such as a strong family history of breast cancer, should discuss their individual risk profile with their healthcare provider 1. Some studies suggest that COCPs may be associated with an increased risk of breast cancer in some women, but this increased risk disappears 10 years after COC discontinuation 1. Key points to consider when prescribing COCPs include:
- The risks of COCs must be weighed against the risks of the condition that they are treating or preventing 1
- COCs are associated with cardiovascular risks, including venous thromboembolic events (VTEs) and myocardial infarction (MI) 1
- The absolute increase in cancer risk for an individual woman is very small, and the overall cancer risk-benefit profile of COCPs is generally considered favorable for most women 1
From the Research
Carcinogen Classification of COCP
- There is no direct evidence in the provided studies that COCP has been increased to the highest level of carcinogen.
- According to 2, the use of COCP may be associated with a slight increase in breast cancer if used under the age of 25 years and for more than 4 to 8 years, and in the risk of cervical cancer.
- 3 states that COCPs exert major protective effects against ovarian and endometrial cancer, which continue many years after cessation of use.
- The studies do not provide information on the current classification of COCP as a carcinogen, and it is unclear if any recent changes have been made to its classification.
Health Risks and Benefits of COCP
- The use of COCP is associated with various health risks, including an increased risk of cardiovascular disease, venous thromboembolism, and certain types of cancer 2, 3, 4.
- However, COCP also has several non-contraceptive benefits, including protection against ovarian and endometrial cancer, and improvement of medical conditions such as acne, endometriosis, and premenstrual dysphoric disorder 5, 6.
- The risk-benefit equation for COCP use depends on individual factors, including age, smoking status, and presence of other health conditions 3, 4.