Invasive squamous‐cell cervical carcinoma and combined oral contraceptives: Results from a multinational study

Geoffrey Berry, Robert Maclennan, Rodney Shearman, Tatiana Jelihovsky, Joan Cooper Booth, Ramiro Molina, Luis Martinez, Oriana Salas, Alfredo Dabancens, Chen Zhiheng, Tao Yun, Hu Yong Wei, Alvaro Cuadros, Nubia Aristizabal, Baruch Modan, Elaine Ron, Esther Alfandary, J. G. Mati, Patrick Kenya, Alfred KunguD. Gatei, Hector Rodriguez Cuevas, Socorro Benavides Salazar, Antonio Palet, Patricia Ontiveros, Pat A. Ibeziako, T. A. Junaid, P. Aghediuno, A. A. Abioye, Ruben A. Apelo, Julietta R. De la Cruz, Jose Baens, Benjamin D. Canlas, Suporn Silpisornkosol, Tieng Pardthaisong, Viruch Charoeniam, Choti Theetranont, Banpot Boosiri, Supawat Chutivongse, Pramuan Virutamasen, Chansuda Wongsrichanalai, Sermsri Sindhavananda, Suporn Koetsawang, Duangdao Rachawat, Amorn Koetsawang, Gustave Riotton, William M. Christopherson, Joseph L. Melnick, Ervin Adam, David B. Thomas, Roberta M. Ray, Elizabeth A. Noonan, Janet L. Stanford, Karin A. Rosenblatt, Susan Holck, Olav Meirik, Timothy M.M. Farley, David B. Thomas, Roberta M. Ray

Research output: Contribution to journalArticlepeer-review


Data from a hospital‐based case‐control study collected in 11 participating centers in 9 countries were analyzed to determine whether use of combined oral contraceptives alters risk of invasive squamous‐cell cervical cancer. Information on prior use of oral contraceptives, screening for cervical cancer, and suspected risk factors for this disease were ascertained from interviews of 2361 cases and 13,644 controls. A history of smoking and anal and genital warts was obtained, and blood specimens were collected for measurement of antibodies against herpes simplex and cytomegalo viruses, from selected sub‐sets of these women, as was a sexual history from interviews of husbands. The relative risk of invasive squamous‐cell cervical carcinoma was estimated to be 1.31, with a 95% confidence interval that excluded one, in women who ever used combined oral contraceptives. Risk of this disease increased significantly with duration of use after 4 to 5 years from first exposure, and declined with the passage of time after cessation of use to that of non‐users in about 8 years. No sources of bias or confounding were identified that offered plausible explanations for these findings. The strength of these results, and their consistency with those from other studies, suggest that a causal relationship may exist between use of combined oral contraceptives and squamous‐cell cervical carcinoma. Women who have used these products for 4 or more years, and who most recently used them within the past 8 years, should receive high priority for cervical cytologic screening.

Original languageEnglish (US)
Pages (from-to)228-236
Number of pages9
JournalInternational Journal of Cancer
Issue number2
StatePublished - Sep 9 1993
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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