Oral contraceptives may improve OS in patients with epithelial ovarian cancer
The use of oral contraceptives appeared associated with longer OS among women with epithelial ovarian cancer, according to results of a prospective cohort study.
“The traditional theory of incessant ovulation as a contributor to ovarian carcinogenesis may support the hypothesis that hormonal changes associated with ovarian suppression due to oral contraceptive use and parity may have long-term effects on tumor biology and host defense mechanisms,” Nonna V. Kolomeyevskaya, MD, fellow in gynecologic oncology at Roswell Park Cancer Institute, and colleagues wrote.
Kolomeyevskaya and colleagues assessed the association between oral contraceptive use and survival among 387 women (aged 18 to 99 years) with epithelial ovarian cancer.
Study participants completed a 16-page questionnaire that assessed medical comorbidities and reproductive factors, such as the use of hormonal medications.
Researchers reported median OS of 81 months among women who reported prior oral contraceptive use vs. 46 months among those who did not use oral contraceptives.
Women who reported prior oral contraceptive use (adjusted HR [aHR] = 0.79; 95% CI, 0.58-1.09), a previous pregnancy (aHR = 0.77; 95% CI, 0.57-1.04) or a live birth (aHR = 0.81; 95% CI, 0.6-1.08) each demonstrated a reduced risk for death.
Kolomeyevskaya and colleagues acknowledged potential limitations, including the single-institution nature of the study and the potential for recall and reporting biases.
“Oral contraceptive use may have lasting effects on epithelial ovarian tumor characteristics, conferring favorable prognosis,” Kolomeyevskaya and colleagues wrote. “Putative mechanisms that affect tumor biology include complex interactions between ovarian cells, host immune cells and hormonal microenvironment during carcinogenesis. Future efforts should be directed to determine the role of reproductive factors in antitumor immunity.” – by Ryan McDonald
Kolomeyevskaya NV, et al. Int J Gynecol Cancer. 2015;doi:10.1097/IGC.0000000000000540.
Disclosure: The researchers report no relevant financial disclosures.