Neoplasia and hormonal contraception

Few issues evoke as much concern and controversy as does the question about whether use of oral contraceptives is associated with the development of cancer. The lay press has been responsible for 'scare' articles that raise the concern of patients about the safety of oral contraceptives. In the scientific literature isolated case reports and preliminary findings in human and animal studies have caused some researchers to call for the withdrawal of oral contraceptives from use with little attempt to weigh possible risk-benefit ratios. There has been extensive documentation of other serious side effects of contraception, e.g., cardiovascular disease and oral contraceptives, and pelvic infections and intrauterine devices. The response of the public and the medical profession to such documentation has been to evaluate the risk-benefit ratio of contraceptive therapy when compared with unplanned pregnancy or induced abortion and to accept the much lower risk of these very effective methods of contraception. It is important to be aware of the patient's concern about the use of oral contraceptives and to be aware of available data on risks and benefits of this method, so that the patient may be guided to the best method of contraception for her particular situation.