Worldwide, more than 100 million women use hormonal methods of contraception. Combined oral contraceptives have previously shown an inverse relationship with ovarian cancer risk. However, changes in the formulations of these contraceptives, including decreases in estrogen dosing, as well as the utilization of newer progestogens, necessitates a re-assessment of the effects of combined oral contraceptives being used today. This prospective, nationwide cohort study enrolled and followed up 1,879,227 Danish women age 15 to 49 years, recording their contraceptive type and history (never users, current users or those that had used contraception within the past year, and former users) to investigate the association between contemporary combined hormonal contraceptives and ovarian cancer risk. Researchers found that current or recent use of contraception was associated with a significantly decreased risk of ovarian cancer (RR 0.58, 95% CI 0.49 to 0.68). Former use of contraception was also associated with a significantly reduced risk of ovarian cancer (RR 0.77, 95% CI 0.66 to 0.91). There was a significant decrease with increasing duration of use of the contraception (p<0.001 for trend). No significant difference was seen between risk estimates with varying progestogen contents across contraceptives. There was also a significant decrease in risk associated with progestogen-only contraceptives (RR 0.72, 95% CI 0.55 to 0.95), though investigators noted this may be secondary to previous combined oral contraceptive use and concluded there is insufficient evidence to determine the effects. This study therefore shows that the use of contemporary combined hormonal contraceptives are associated with a reduction in ovarian cancer risk in women of reproductive age.
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