Deaths from ovarian cancer decline worldwide due to oral contraceptive use

This month a report was published in one of the leading cancer journals, Annals of Oncology, lead by Professor Carlo La Vecchia from the Faculty of Medicine, University of Milan, Italy reporting that ovarian cancer mortality rates have levelled or declined globally.

The results show that between 2002 and 2012, deaths from ovarian cancer fell by 10% in the EU and 16% in the USA and are predicted to continue to fall.  Rates also decreased in Canada, Japan and other countries.

The rate in the EU varied widely between countries;  22% decrease in the UK compared with just 0.5% in Hungary.

The oral contraceptive pill has a long-term protective effect on ovarian cancer risk and hormone therapy (HRT) has a negative effect.  HRT is a recognised risk factor for ovarian cancer after the Women’s Health Initiative report in 2002 and its use has declined in countries such as Germany, UK and USA.  These countries had the highest levels of ovarian cancer in the past.  The decline in ovarian cancer is seen more in younger and middle aged women as they have taken the oral contraceptive pill earlier.  Breast feeding is protective against ovarian cancer.  Advances in diagnosis and treatment will also have a favourable affect.

The authors concluded:  “The main reason for the favourable trends is the use of oral contraceptives (OCs), particularly, in the USA and countries of the EU where OCs were introduced earlier. Declines in menopausal hormone use may also have played a favourable role in elderly women, as well as improved diagnosis, management and treatment.”

Prof La Vecchia said: “The large variations in death rates between European countries have reduced since the 1990s when there was a threefold variation across Europe from 3.6 per 100,000 in Portugal to 9.3 in Denmark. This is likely to be due to more uniform use of oral contraceptives across the continent, as well as reproductive factors, such as how many children a woman has. However, there are still noticeable differences between countries such as Britain, Sweden and Denmark, where more women started to take oral contraceptives earlier — from the 1960s onwards — and countries in Eastern Europe, but also in some other Western and Southern European countries such as Spain, Italy and Greece, where oral contraceptive use started much later and was less widespread.  This mixed pattern in Europe also helps to explain the difference in the size of the decrease in ovarian cancer deaths between the EU and the USA, as many American women also started to use oral contraceptives earlier.”

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Global women – ovarian cancer

Read the paper here.