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BMJ. 2007 November 17; 335(7628): 1017.
PMCID: PMC2078628
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Excess risk of cervical cancer in pill users falls once pills are stopped

In 2005, the International Agency for Research on Cancer classified combined oral contraceptives as carcinogenic because of a significant association with cervical cancer. The report's authors challenged researchers to find out how long the risk lasted once women stopped taking their pills. A meta-analysis of about 85% of the known research on this topic finds that the excess risk decays relatively quickly, has disappeared completely within 10 years (relative risk of invasive cancer 1.65 for current users, falling to 1.05 after 10 years), and is confined to women who used combined oral contraceptives for at least five years.

Do hormonal contraceptives really cause cervical cancer? It is hard to say for certain, says a commentary (p 1591). Hormonal contraceptives may interact with human papillomaviruses to increase the likelihood that infection persists or to cause premalignant changes in the cervix. But it is also possible that these associations are simply the result of residual confounding. Women who use hormonal contraceptives have more sex than women who don't (although the researchers did their best to adjust for this), and they are less likely to use barrier methods—such as condoms—that protect against infection with human papillomaviruses. Women shouldn't let fear of cervical cancer stop them from taking effective hormonal contraceptives, the comment concludes.


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