Birth control pills or oral contraceptives became available to women in American in the early 1960s. Today, because of their effectiveness, reversibility of action and convenience, the birth control pill has become the most widely used form of birth control in the United States. However, ever since the pill has been introduced investigators have conducted various studies as how the pill relates to cancer and to smoking.

There are basically two types of oral contraceptives that are available in the United States to women today. The most commonly prescribed birth control pill is composed of two man-made versions of hormones that are naturally found in the female, namely estrogen and progesterone. This is often referred to as a “combined oral contraceptive”. The second type of birth control pill contains only a kind of progesterone and is known as the mini-pill.


Due to the fact that medical research contends that some cancers depend upon sex hormones that naturally occur in the body for their development as well as their growth, scientific researchers have been looking into a possible link between the birth control pill and the risk of getting certain types of cancer. It seems that the risk of ovarian and endometrial cancer is reduced with the use of oral contraceptives while the risk of cervical and breast cancer is increased.


Several factors can lead to a woman’s risk of developing breast cancer. Some of these risks are related to natural hormones. There are certain factors in a woman’s body that may allow high levels of naturally occurring hormone to persist for a very long time such as starting menstruation before the age of 12, having a first child after she is thirty years old, experiencing late menopause usually after the age of 55 and never having children.

In 1996, a study was conducted and showed that women who were currently using oral contraceptives or had just stopped using the pill, had a slightly greater risk of contracting breast cancer. The risk was highest in that category of women who had begun using the pill as teenagers. However, after these women had been off the pill for ten years or more, their risk for developing breast cancer returned to the normal level as if they had never used oral contraceptives in the first place. In another study, women who were diagnosed with breast cancer were queried if they had used oral contraceptives for a period of more than six months prior to their diagnosis. If they gave a positive response, then they were asked whether their most recent use of the pill has been within five years, were between five to ten years or were more than ten years. The highest risk of getting breast cancer was the group of women who had used oral contraceptives within five years before the diagnosis of breast cancer, especially in the younger group of women.


How do birth control pills affect endometrial and ovarian cancer risk? Studies across the board have been consistent in showing that oral contraceptives do reduce the risk of a woman developing ovarian cancer. Researchers from Harvard Medical School found that the risk of developing ovarian cancer diminished with the prolonged use of the pill. One study from Harvard found that it did not matter as to the type of the amount of progestin or estrogen in the pill; the risk of developing ovarian cancer was still reduced.


The use of oral contraceptives has been shown to significantly lower the risk of developing endometrial cancer. The longer the woman takes the pill, the more the effect increases that she will not develop endometrial cancer. This effect continues for many years after a woman stops using oral contraceptives.


What is the effect of oral contraceptives on cervical cancer? Evidence indicates that when a woman uses oral contraceptives for a long time, there may be an increased chance of developing cancer of the cervix. It is also known that there are about fourteen types of the human papillomavirus that have the chance of causing cervical cancer. When cervical cancer biopsies were performed, it was found that 99% of them were caused by HPVs. After a woman has stopped taking the pill, her risk for developing cervical cancer diminishes.


How does taking oral contraceptives affect the woman’s risk of developing liver cancer? Several studies suggest that oral contraceptives increase the risk of a woman developing liver cancer in low risk populations such as white females in the U.S. and Europe who do not have any disease of the liver. In these studies, it was found that women who used the pill for extended periods of time were found to be at an increased risk for developing liver cancer. However, this risk did not increase among African and Asian women who were already considered at a high risk for contracting liver cancer.


For the cancers that have been described above, what screening tests are available today? Studies have conclusively found that women from the ages of 40 to 69 who have annual breast screenings and mammograms reduce the number of deaths from breast cancer. Women who are at a greater risk for developing breast cancer should seek the advice of their physician as to when they should begin to have mammograms and how often they should be screened. If a woman gets a high-quality mammogram along with a clinical breast exam every year, then this is the most effective way to detect breast cancer in its early stages.


A woman should also have a yearly Pap test done as this can pick up any abnormal changes in the cervix. Women who have started to have sexual intercourse or are at least 21 should check with their physician about having a Pap test. Researchers are now working on coming up with screening tests for endometrial and ovarian cancer. As always, if a woman is concerned about her risk for developing cancer, she is encouraged to speak with her physician about her concerns.


The last thing to be covered is the link between cigarette smoking and taking oral contraceptives. If a woman smokes while taking the pill, she runs the risk of developing serious cardiovascular side effects. The heavy smoker is put at a greater risk. Also, the risk of developing cardiovascular disease increases when a woman is over the age of 35 and takes the pill. Women who are taking oral contraceptives should be advised very strongly not to smoke. There are also increased risks for developing heart attacks, stroke, blood clots, gallbladder disease and liver cancer. However, the risk is quite small in healthy women who do not have any underlying risk factors.


To sum up then, if you are taking any oral contraceptives, it would be well to have your annual screenings as well as to be aware of any symptoms that may be out of the ordinary. It would be best, however, if you did not have to use the pill at all.