Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2026, Vol. 22 ›› Issue (04): 298 -304. doi: 10.3877/cma.j.issn.1673-5250.2026.04.004

Forum

Current research status on relationship between compound oral contraceptives and gynecological malignant tumors

Fangli Liu1, Jinke Li2, Min Hao1,()   

  1. 1Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China;
    2Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2026-01-31 Revised:2026-07-01 Published:2026-08-01
  • Corresponding author: Min Hao
  • Supported by:
    Youth Project of the Basic Research Program (Free Exploration Category) of the Department of Science and Technology of Shanxi Province(202503021212349)

Compound oral contraceptives (COC) are highly effective contraceptive methods used worldwidely in female contraception, abnormal uterine bleeding, endometriosis (EMT) and other gynecological benign diseases. However, the estrogen or progesterone components of COC may increase the risk of cardiovascular diseases or estrogen-related tumors in those who take it. With the continuous reduction of estrogen content of COC, the risk of related diseases has decreased. However, the safety of long-term use of estrogen and progesterone, as well as their potential connections with the occurrence and development of various tumors, have not yet been clarified. The authors intend to elaborate on the current research status of the relationship between COC and gynecological malignant tumors.

[1]
United Nations, Department of Economic and Social Affairs. Population division contraceptive use by method 2019 (data booklet)[M]. New York: United Nations, 2019. DOI: 10.18356/1bd58a10-en.
[2]
国务院第七次全国人口普查领导小组办公室. 中国人口普查年鉴:2020[M]. 北京:中国统计出版社,2022.
[3]
Sands MI. Oral contraceptives and cardiovascular risk[J]. Drug Therap Bullet, 2000, 38(1): 1-5. DOI: 10.1136/dtb.2000.3811-a.
[4]
Dumeaux V, Alsaker E, Lund E. Breast cancer and specific types of oral contraceptives: a large Norwegian cohort study[J]. Int J Cancer, 2003, 105(6): 844-850. DOI: 10.1002/ijc.11167.
[5]
Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2024, 74(3): 229-263. DOI: 10.3322/caac.21834.
[6]
孙可欣,李荔,王少明,等. 2024年中国分地区恶性肿瘤流行情况分析[J]. 中华肿瘤杂志2026, 48(3): 400-412. DOI: 10.3760/cma.j.cn112152-20260205-00079.
[7]
Arshadi M, Hesari E, Ahmadinezhad M, et al. The association between oral contraceptive pills and ovarian cancer risk: a systematic review and Meta-analysis[J]. Bull Cancer, 2024, 111(10): 918-929. DOI: 10.1016/j.bulcan.2024.05.010.
[8]
Karlsson T, Johansson T, Höglund J, et al. Time-dependent effects of oral contraceptive use on breast, ovarian, and endometrial cancers[J]. Cancer Res, 2021, 81(4): 1153-1162. DOI: 10.1158/0008-5472.CAN-20-2476.
[9]
Collaborative Group on Epidemiological Studies of Ovarian Cancer, Beral V, Doll R, et al. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23, 257 women with ovarian cancer and 87,303 controls[J]. Lancet, 2008, 371(9609): 303-314. DOI: 10.1016/S0140-6736(08)60167-1.
[10]
Chen S, Li L, Wang H, et al. Oral contraceptives use and ovarian cancer risk in Chinese BRCA mutation carriers: a case-control study[J]. Gynecol Oncol, 2025, 157(2): 389-395. DOI: 10.1016/j.ygyno.2025.02.015.
[11]
Moorman PG, Havrilesky LJ, Gierisch JM, et al. Oral contraceptives and risk of ovarian cancer and breast cancer among high-risk women: a systematic review and Meta-analysis[J]. J Clin Oncol, 2013, 31(33): 4188-4198. DOI: 10.1200/JCO.2013.48.9021.
[12]
Schrijver LH, Antoniou AC, Olsson H, et al. Oral contraceptive use and ovarian cancer risk for BRCA1/2 mutation carriers: an international cohort study[J]. Am J Obstet Gynecol, 2021, 225(1): 51.e1-51.e17. DOI: 10.1016/j.ajog.2021.01.014.
[13]
Beral V, Million Women Study Collaborators, Bull D, et al. Ovarian cancer and hormone replacement therapy in the million women study[J]. Lancet, 2007, 369(9574): 1703-1710. DOI: 10.1016/S0140-6736(07)60534-0.
[14]
Gaitskell K, Green J, Pirie K, et al. Tubal ligation and ovarian cancer risk in a large cohort: substantial variation by histological type[J]. Int J Cancer, 2016, 138(5): 1076-1084. DOI: 10.1002/ijc.29856.
[15]
Fernandes I, Coelho R, Figueiredo-Dias M, et al. The role of progesterone in ovarian cancer: from tumour suppression to therapeutic target:an updated mini-review[J]. Eur J Gynaecol Oncol, 2025, 46(10): 5-13. DOI: 10.22514/ejgo.2025.126.
[16]
Avramenko AS, Flanagan JM. An epigenetic hypothesis for ovarian cancer prevention by oral contraceptive pill use[J]. Clin Epigenetics, 2023, 15(1): 165. DOI: 10.1186/s13148-023-01584-9.
[17]
Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2022[J]. CA Cancer J Clin, 2022, 72(1): 7-33. DOI: 10.3322/caac.21708.
[18]
李婧,林仲秋,卢淮武. 低危型早期宫颈癌患者手术渐趋保守,我们应该如何应对[J/OL]. 中华妇幼临床医学杂志(电子版), 2025, 21(5): 502-507. DOI: 10.3877/cma.j.issn.1673-5250.2025.05.002.
[19]
中华预防医学会生殖健康分会. 子宫内膜癌诊治微创无瘤防御管理指南(2025年版)[J]. 中国实用妇科与产科杂志2025, 41(9): 905-913. DOI: 10.19538/j.fk2025090111.
[20]
Iversen L, Fielding S, Lidegaard Ø,et al. Contemporary hormonal contraception and risk of endometrial cancer in women younger than age 50: a retrospective cohort study of Danish women[J]. Contraception, 2020, 102(3): 152-158. DOI: 10.1016/j.contraception.2020.06.008.
[21]
World Health Organization. Cervical cancer[R/OL]. (2025-12-02) [2026-04-07].

URL    
[22]
郑荣寿,张思维,孙可欣,等. 2016年中国恶性肿瘤流行情况分析[J]. 中华肿瘤杂志2024, 45(3): 212-220. DOI: 10.3760/cma.j.cn112152-20220922-00647.
[23]
Moodley M, Moodley J, Chetty R, et al. The role of steroid contraceptive hormones in the pathogenesis of invasive cervical cancer: a review[J]. Int J Gynecol Cancer, 2003, 13(2): 103-110. DOI: 10.1046/j.1525-1438.2003.13030.x.
[24]
International Collaboration of Epidemiological Studies of Cervical Cancer, Appleby P, Beral V, et al. Cervical cancer and hormonal contraceptives: collaborative reanalysis of individual data for 16,573 women with cervical cancer and 35,509 women without cervical cancer from 24 epidemiological studies[J]. Lancet, 2007: 370(9599): 1609-1621. DOI: 10.1016/S0140-6736(07)61684-5.
[25]
International Collaboration of Epidemiological Studies of Cervical Cancer. Cervical carcinoma and reproductive factors: collaborative reanalysis of individual data on 16, 563 women with cervical carcinoma and 33,542 women without cervical carcinoma from 25 epidemiological studies[J]. Int J Cancer, 2006, 119(5): 1108-1124. DOI: 10.1002/ijc.21953.
[26]
Castellsagué X, Díaz M, de Sanjosé S, et al. Worldwide human papillomavirus etiology of cervical adenocarcinoma and its cofactors: implications for screening and prevention[J]. J Natl Cancer Inst, 2006, 98(5): 303-315. DOI: 10.1093/jnci/djj067.
[27]
Asthana S, Busa V, Labani S. Oral contraceptives use and risk of cervical cancer: a systematic review & Meta-analysis[J]. Eur J Obstet Gynecol Reprod Biol, 2020, 247: 163-175. DOI: 10.1016/j.ejogrb.2020.02.014.
[28]
Marks M, Gravitt PE, Gupta SB, et al. Combined oral contraceptive use increases HPV persistence but not new HPV detection in a cohort of women from Thailand[J]. J Infect Dis, 2011, 204(10):1505-1513. DOI: 10.1093/infdis/jir560.
[29]
Gierisch JM, Coeytaux RR, Urrutia RP, et al. Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review[J]. Cancer Epidemiol Biomarkers Prev, 2013, 22(11): 1931-1943. DOI: 10.1158/1055-9965.EPI-13-0298.
[30]
Moodley M, Sewart S, Herrington CS, et al. The interaction between steroid hormones, human papillomavirus type 16, E6 oncogene expression, and cervical cancer[J]. Int J Gynecol Cancer, 2003, 13(6): 834-842. DOI: 10.1111/j.1525-1438.2003.13380.x.
[31]
Ramachandran B. Functional association of oestrogen receptors with HPV infection in cervical carcinogenesis[J]. Endocr Relat Cancer, 2017, 24(4): R99-R108. DOI:10.1530/ERC-16-0571.
[32]
Shew ML, McGlennen R, Zaidi N, et al. Oestrogen receptor transcripts associated with cervical human papillomavirus infection[J]. Sex Transm Infect, 2002, 78(3): 210-214. DOI: 10.1136/sti.78.3.210.
[33]
Hellberg D. Sex steroids and cervical cancer[J]. Anticancer Res, 2012, 32(8): 3045-3054.
[34]
Torres-de la Roche LA, Acevedo-Mesa A, Lizarazo IL, et al. Hormonal contraception and the risk of breast cancer in women of reproductive age: a Meta-analysis[J]. Cancers (Basel), 2023, 15(23): 5624. DOI: 10.3390/cancers15235624.
[35]
Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022[J]. J Natl Cancer Cent, 2024, 4(1): 47-53. DOI: 10.1016/j.jncc.2024.01.006.
[36]
Burchardt NA, Eliassen AH, Shafrir AL, et al. Oral contraceptive use by formulation and breast cancer risk by subtype in the Nurses′ Health Study Ⅱ:a prospective cohort study[J]. Am J Obstet Gynecol, 2022, 226(6): 821.e1-821.e26. DOI: 10.1016/j.ajog.2021.12.022.
[37]
Fitzpatrick D, Pirie K, Reeves G, et al. Combined and progestagen-only hormonal contraceptives and breast cancer risk: a UK nested case-control study and Meta-analysis[J]. PLoS Med, 2023, 20(3): e1004188. DOI: 10.1371/journal.pmed.1004188.
[38]
Gaffield ME, Culwell KR, Ravi A. Oral contraceptives and family history of breast cancer[J]. Contraception, 2009, 80(4): 372-380. DOI: 10.1016/j.contraception.2009.04.010.
[39]
Ozmen V, Ozcinar B, Karanlik H, et al. Breast cancer risk factors in Turkish women: a university hospital based nested case control study[J].World J Surg Oncol, 2009, 7: 37. DOI: 10.1186/1477-7819-7-37.
[40]
Schrijver LH, Olsson H, Phillips KA, et al. Oral contraceptive use and breast cancer risk: retrospective and prospective analyses from a BRCA1 and BRCA2 mutation carrier cohort study[J]. JNCI Cancer Spectr, 2018, 2(2): pky023. DOI: 10.1093/jncics/pky023.
[41]
Kotsopoulos J, Lubinski J, Moller P, et al. Timing of oral contraceptive use and the risk of breast cancer in BRCA1 mutation carriers [J]. Breast Cancer Res Treat, 2014, 143(3): 579-586. DOI: 10.1007/s10549-013-2823-4.
[1] Changxian Chen, Zhongfen Luo, Li Li. Current research status on angiogenesis inhibitors in treatment of patients with platinum-resistant recurrent ovarian cancer[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2026, 22(04): 290-297.
[2] Minhua Xu, Yuan Fang, Lijun Zhu, Yulin Yang. Willingness and influencing factors of cervical and breast cancer screening among women[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2026, 22(03): 250-258.
[3] Zuli Fan, Huiwen Tan, Huili Zhu. Interpretation of the Clinical Practice Guideline for the Evaluation of Androgen Excess in Women: from mechanism to practice[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2026, 22(03): 204-213.
[4] Ziyang Liu, Wandai Wu, Zhengyu Li. Efficacy of postoperative hyperthermic intraperitoneal chemotherapy in patients with early stage epithelial ovarian cancer[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2026, 22(02): 117-127.
[5] Chuanyu Liu, Jianguo Hu, Li Wang, Xinyue Xu, Shuai Diao, Qian Yang, Lina Hu. Multicenter retrospective clinical analysis of special types of cervical adenocarcinoma[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2026, 22(02): 128-139.
[6] Wei Chen, Jie Fang. Expression levels of peripheral blood circular RNA ATRNL1 and follistatin in patients with endometrial polyp and their predictive value for recurrence after hysteroscopic resection[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2026, 22(02): 140-147.
[7] Shunyao Meng, Jing Zeng, Rutie Yin. Current research status of immunotherapy for gestational trophoblastic neoplasia[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2026, 22(01): 1-6.
[8] Daying Wu, Guiling Li. Current research status on immunotherapy for patients with endometrial carcinoma[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2026, 22(01): 7-12.
[9] Guanghao Yang, Zhenyan Liu, Hongying Yang. Current research status on poly ADP-ribose polymerase inhibitors and regulation of immunotherapy for patients with ovarian cancer[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2026, 22(01): 13-18.
[10] Lin Zhang, Shiqian Zhang. Interpretation of Chinese Expert Consensus on Standardized Surgical Treatment for Ovarian Cancer in Elderly Patients (2024 Edition)[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2025, 21(06): 605-610.
[11] Haiqi Tian, Zhangmei Hou, Jiarui Li, Cheng Chen, Xiaoyan Liu. Analysis of factors influencing postoperative infection in patients with gynecological malignant tumors[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2025, 21(06): 689-696.
[12] Jin He, Shengtao Zhou. Evaluation and clinical considerations for fertility-sparing treatment in young patients with early-stage endometrial cancer[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2025, 21(05): 495-501.
[13] Shaolong Xue, Bowen Yang, Mingrong Xi. Interpretation of the Chinese Expert Consensus on Surgical Treatment of Endometrial Cancer in the Elderly (2024 Edition)[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2025, 21(05): 508-515.
[14] Junxi Liu, Jin Wu. Interpretation of the Clinical Practice Guidelines for the Care of Girls and Women with Turner Syndrome[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2025, 21(05): 516-524.
[15] Yanan Li, Xianghua Huang. Application of vaginal endoscopy in the diagnosis and treatment of female genital tract congenital anomalies[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2026, 19(02): 77-82.
Viewed
Full text


Abstract