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Oral Contraceptives Can Improve Outcomes in Ovarian Cancer

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A retrospective study conducted at the Mayo Clinic found improved OS and PFS in ovarian cancer patients with a history of oral contraceptive use.

While the cancer-preventive role of oral contraceptives is well established, a new study, published in BMC Cancer, has found that prior oral contraceptive use can also improve treatment outcomes in patients with ovarian cancer.

Women with invasive primary epithelial ovarian, fallopian tube, or peritoneal cancer were recruited between 2000 and 2013 at the Mayo Clinic in Rochester, MN. Of the many other questions on a risk-factor survey, patients were queried on prior contraceptive usage. The patients’ electronic medical records were used to extract records on tumor histology, type of surgery, and administration of chemotherapy. Outcome data on cancer recurrence were acquired through April 2014.

Of the 1398 ovarian cancer patients who provided information on oral contraceptive use, about 40% (571) had not used oral contraceptives. Analysis of the remaining 60% patients found that oral contraceptive use was associated with better overall survival (hazard ratio (HR), 0.73; 95 % confidence interval (CI), 0.62,-0.86; P = .0002) as well as better progression-free survival (HR, 0.71; 95% CI, 0.61-0.83; P<.0001).

While the exact mechanism of this effect of oral contraceptives is an unknown, hypotheses exist, said co-lead author Aminah Jatoi, MD, an oncologist at Mayo Clinic. According to Jatoi, by halting ovulation, oral contraceptives protect against the repeated monthly changes that occur on the surface of the ovary. Contraceptives may reduce the risk of DNA mutations and thereby result in a less aggressive form of the disease at a later date.

“Without question, further studies are needed in this area, but our study might provide a sense of hope for patients who are struggling with ovarian cancer,” says Jatoi.

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