Oral contraceptives use and risk of cervical cancer-A systematic review & meta-analysis

Abstract

Background: Role of Oral Contraceptive (OC) as a risk factor for cervical cancer remained controversial and unclear.

Objective: To evaluate risk of cervical cancer in OC users and non-users through a comprehensive systematic review.

Search strategy: Literature search conducted in databases from January 1990 till August 2019 using various search terms.

Selection criteria: Primary research studies that evaluated and assessed the association of OC use with cervical cancer with study design of case control or cohort types published in English language.

Data collection and analysis: PRISMA guided review was done by two independent researchers. Effect size estimated by pooled Odds ratio with 95 % Confidence Interval (CI) in random effect models on OC pill use for the risk of cervical cancer.

Results: Review included 19 studies. Overall risk of invasive cancer on OC use was found to be significant with unknown status of HPV OR (95 % CI) as 1.51 (1.35, 1.68) and for unknown HPV as 1.66 (1.24, 2.21). Adenocarcinoma, squamous cell carcinoma and carcinoma in situ had significant association with OR (95 % CI) of 1.77 (1.4, 2.24), 1.29 (1.18, 1.42) and 1.7 (1.18, 2.44) respectively.

Conclusion: OC pills use had a definite associated risk for developing cervical cancer specially for Adenocarcinoma and longer duration of OC pills use.

Keywords: Cervical cancer; Meta-analysis; OC pills; Risk; Systematic review.