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Ovarian Cancer Prevention (PDQ®): Prevention - Health Professional Information [NCI] - Summary of Evidence

Note: Separate PDQ summaries on Ovarian Cancer Screening and Ovarian Epithelial Cancer Treatment are also available.

Oral Contraceptives: Benefits

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General Information About Ovarian Epithelial Cancer

Incidence and Mortality Estimated new cases and deaths from ovarian cancer in the United States in 2013:[1] New cases: 22,240. Deaths: 14,030. Several malignancies arise from the ovary. Epithelial carcinoma of the ovary is one of the most common gynecologic malignancies and the fifth most frequent cause of cancer death in women, with 50% of all cases occurring in women older than 65 years.[2] Approximately 5% to 10% of ovarian cancers are familial, and three distinct hereditary...

Read the General Information About Ovarian Epithelial Cancer article > >

Based on solid evidence, oral contraceptive use is associated with a decreased risk of developing ovarian cancer.

Description of the Evidence

  • Study Design: Evidence obtained from multiple case-control and cohort studies.
  • Internal Validity: Good.
  • Consistency: Good.
  • Magnitude of Effects on Health Outcomes: A relative risk (RR) reduction of about 50% overall with a dose response ranging from 5% to 10% RR reduction per year of use to maximum RR reductions of up to 80%.
  • External Validity: Good.

Oral Contraceptives: Harms

Based on solid evidence, combined current use of estrogen/progestogen oral contraceptive use is associated with an increased risk of venous thromboembolism. Oral contraceptives are not associated with a long-term increased risk of breast cancer but may be associated with a short-term increased risk while a woman is taking oral contraceptives. The risk of breast cancer declines with time since last use.

Description of the Evidence

  • Study Design: Evidence obtained from observational studies.
  • Internal Validity: Good.
  • Consistency: Good.
  • Magnitude of Effects on Health Outcomes: The risks may vary by preparation. Overall, the absolute risk of venous thromboembolism is about three events per 10,000 women per year while taking oral contraceptives. The risk is increased by smoking. Breast cancer risk among long-term (>10 years) current users is estimated at one extra case per year per 100,000 women. The risk dissipates with time since last use.
  • External Validity: Good.

Prophylactic Oophorectomy: Benefits

Based on solid evidence, prophylactic bilateral oophorectomy is associated with a decreased risk of ovarian cancer. Peritoneal carcinomatosis has been reported following prophylactic removal of the ovaries. Prophylactic oophorectomy, along with salpingo-oophorectomy, is generally reserved for women at high risk of developing ovarian cancer, such as women who have a deleterious mutation in a BRCA1 or BRCA2 gene.

Description of the Evidence

  • Study Design: Evidence obtained from multiple case-control and cohort studies.
  • Internal Validity: Good.
  • Consistency: Good.
  • Magnitude of Effects on Health Outcomes: 90% reduction in risk of ovarian cancer observed among women with a BRCA1 or BRCA2 mutation.
  • External Validity: Good.
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