CONTRACEPTIVE USE AND OVARIAN CANCER OUTCOME

Patients who develop ovarian cancer appear to have better outcomes if they have a history of oral contraceptive use, according to a study by Mayo Clinicresearchers published by Jatoi et al in BMC Cancer.

“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,” said Aminah Jatoi, MD, an oncologist at the Mayo Clinic. “However, few studies have explored the connection between the pill and outcomes in patients who ultimately develop the disease.”

Study Details

In their study, Dr. Jatoi and coauthor Ellen L. Goode, PhD, an epidemiologist at the Mayo Clinic, examined the outcomes of ovarian cancer patients who were seen at Mayo Clinic from 2000 through 2013. Each patient was given a risk factor questionnaire about prior oral contraceptive use. Of the 1,398 patients who completed the questionnaire, 827 responded that they had previously taken birth control pills.

The researchers performed two types of statistical analysis on the clinical data extracted from the patients' electronic health records. One analysis found that patients who had been on the pill had improved progression-free survival and improved overall survival compared with those who had not.

A second type of statistical analysis provided less consistent findings, indicating a statistically significant association between oral contraceptive use and progression-free survival but not overall survival. The researchers think that one possible explanation for the latter finding was older patients who had passed away may have died of noncancer causes, although other factors may have come into play.

Although it is still not clear how oral contraceptives improve outcomes for patients with ovarian cancer, Dr. Jatoi said there are various hypotheses. For example, by halting ovulation, oral contraceptives protect against the repeated monthly changes that occur on the surface of the ovaries. Contraceptives may reduce the risk of DNA mutations and thereby result in a less-aggressive form of the disease at a later date.

Dr. Jatoi said the study findings underscore the need for research into the mechanisms driving a more favorable prognosis for women who used the pill. Such knowledge may one day provide researchers with new therapeutic targets to create better outcomes for patients diagnosed with ovarian cancer. “Without question, further studies are needed in this area,” said Dr. Jatoi, “but our study might provide a sense of hope for patients who are struggling with ovarian cancer.”