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Oral contraceptive use associated with improved survival in ovarian cancer
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Women with ovarian cancer have better survival outcomes if they have a history of oral contraceptive use, according to results of a retrospective cohort study.
Although the reason for this benefit remains unclear, researchers hypothesized it could be related to the prevention of ovulation. By reducing changes to the ovaries as they release eggs, the risk for genetic mutations could be reduced, resulting in less aggressive cancers.
“Multiple studies from a variety of sources have indicated that oral contraceptives are associated with a reduced risk of ovarian cancer, one of the most deadly cancers in women,” Aminah Jatoi, MD, an oncologist and professor of oncology at Mayo Clinic in Rochester, Minnesota, said in a press release. “However, few studies have explored the connection between the pill and outcomes in patients who ultimately develop the disease.”
The researchers analyzed data from women with ovarian cancer treated at Mayo Clinic in Rochester between 2000 and 2013.
Overall, 1,398 women completed a questionnaire that included questions about previous oral contraceptive use.
More than half of the cohort (n = 827; 59.1%) reported using contraceptives. Median duration of use was 5 years (range, 1 month to 37 years).
Univariate analysis showed use of oral contraceptives was associated with longer OS (HR = 0.73; 95% CI, 0.62-0.86) and PFS (HR = 0.71; 95% CI, 0.61-0.83). On multivariate analysis, the PFS benefit remained statistically significant but the OS benefit did not.
Researchers acknowledged study limitations. The questionnaire did not assess specific types of oral contraceptives, which could enhance the data given progesterone content seems to carry a more protective effect. Also, cause-specific mortality was not assessed, which could have affected OS outcomes in the multivariable analysis.
Finally, there were limited data on the timing of the use of oral contraceptives, which could impact the strength of the association between the contraceptives and the aggressiveness of the ovarian cancer.
“Despite such limitations, our study — coupled with several that preceded it — points to a need to investigate mechanisms that explain how and why prior oral contraceptive use appears to improve clinical outcomes in ovarian cancer patients,” Jatoi and colleagues wrote. “Understanding such mechanisms might lead to more effective therapeutic interventions in patients diagnosed with this malignancy.” – by Anthony SanFilippo
Disclosure: The researchers report no relevant financial disclosures.
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