Skip to main content
NCBI home page
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1986 May 24;292(6532):1357–1361. doi: 10.1136/bmj.292.6532.1357

Cancer of the liver and the use of oral contraceptives.

D Forman, T J Vincent, R Doll
PMCID: PMC1340367  PMID: 3011186

Abstract

A case-control study of the use of oral contraceptives was conducted among women certified as having died from cancer of the liver in the period 1979-82 and in the age range 20-44 years. An age matched group of women who died from other causes, not related to use of oral contraceptives, in the same period were used as controls. Information about use of oral contraceptives was obtained from the general practitioners' notes for both cases and controls. Information was obtained for 30 women with histologically confirmed liver cancer, 19 with hepatocellular carcinoma and 11 with cholangiocarcinoma, and for 147 controls. The results were analysed after adjusting for age at diagnosis and year of birth and showed that use of oral contraceptives was associated with a significantly (p less than 0.05) raised relative risk for hepatocellular carcinoma of 3.8 (95% confidence interval 1.0 to 14.6) and use for eight years or more was associated with a significantly (p less than 0.01) increased relative risk of 20.1 (2.3 to 175.7). There were no apparent increases in risk for cholangiocarcinoma. Despite the small number of cases in this study and the methodological problems in assessing use of oral contraceptives from general practitioners' notes, the results were consistent with other similar studies. Although in the United Kingdom primary liver cancer remains an exceptionally rare disease, especially in young women, further research on the role of oral contraceptives is needed in those countries where it is a much more common disease.

Full text

PDF
1357

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Coulter A., Vessey M., McPherson K., Crossley B. The ability of women to recall their oral contraceptive histories. Contraception. 1986 Feb;33(2):127–137. doi: 10.1016/0010-7824(86)90079-x. [DOI] [PubMed] [Google Scholar]
  2. Davis M., Portmann B., Searle M., Wright R., Williams R. Histological evidence of carcinoma in a hepatic tumour associated with oral contraceptives. Br Med J. 1975 Nov 29;4(5995):496–498. doi: 10.1136/bmj.4.5995.496. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Edmondson H. A., Henderson B., Benton B. Liver-cell adenomas associated with use of oral contraceptives. N Engl J Med. 1976 Feb 26;294(9):470–472. doi: 10.1056/NEJM197602262940904. [DOI] [PubMed] [Google Scholar]
  4. Farrell G. C., Joshua D. E., Uren R. F., Baird P. J., Perkins K. W., Kronenberg H. Androgen-induced hepatoma. Lancet. 1975 Feb 22;1(7904):430–432. doi: 10.1016/s0140-6736(75)91494-4. [DOI] [PubMed] [Google Scholar]
  5. Forman D., Doll R., Peto R. Trends in mortality from carcinoma of the liver and the use of oral contraceptives. Br J Cancer. 1983 Sep;48(3):349–354. doi: 10.1038/bjc.1983.199. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hardell L., Bengtsson N. O., Jonsson U., Eriksson S., Larsson L. G. Aetiological aspects on primary liver cancer with special regard to alcohol, organic solvents and acute intermittent porphyria--an epidemiological investigation. Br J Cancer. 1984 Sep;50(3):389–397. doi: 10.1038/bjc.1984.188. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Henderson B. E., Preston-Martin S., Edmondson H. A., Peters R. L., Pike M. C. Hepatocellular carcinoma and oral contraceptives. Br J Cancer. 1983 Sep;48(3):437–440. doi: 10.1038/bjc.1983.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Mays E. T., Christopherson W. Hepatic tumors induced by sex steroids. Semin Liver Dis. 1984 May;4(2):147–157. doi: 10.1055/s-2008-1040654. [DOI] [PubMed] [Google Scholar]
  9. McLaughlin J. K., Blot W. J., Mehl E. S., Mandel J. S. Problems in the use of dead controls in case-control studies. II. Effect of excluding certain causes of death. Am J Epidemiol. 1985 Sep;122(3):485–494. doi: 10.1093/oxfordjournals.aje.a114130. [DOI] [PubMed] [Google Scholar]
  10. Neuberger J., Portmann B., Nunnerley H. B., Laws J. W., Davis M., Williams R. Oral-contraceptive-associated liver tumours: occurrence of malignancy and difficulties in diagnosis. Lancet. 1980 Feb 9;1(8163):273–276. doi: 10.1016/s0140-6736(80)90776-x. [DOI] [PubMed] [Google Scholar]
  11. Rooks J. B., Ory H. W., Ishak K. G., Strauss L. T., Greenspan J. R., Hill A. P., Tyler C. W., Jr Epidemiology of hepatocellular adenoma. The role of oral contraceptive use. JAMA. 1979 Aug 17;242(7):644–648. [PubMed] [Google Scholar]
  12. Vana J., Murphy G. P. Primary malignant liver tumors: association with oral contraceptives. N Y State J Med. 1979 Mar;79(3):321–325. [PubMed] [Google Scholar]
  13. Yager J. D., Jr, Yager R. Oral contraceptive steroids as promoters of hepatocarcinogenesis in female Sprague-Dawley rats. Cancer Res. 1980 Oct;40(10):3680–3685. [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES