The World Health Organisation’s International Agency for Research on Cancer has taken the dramatic step of deeming menopausal therapies and contraceptives that combine oestrogen with progestogen as “carcinogenic to humans.” However, it is quick to point out that there are both beneficial and adverse effects for all products, and that these should be discussed on an individual basis.

However, the news will do little to comfort a market already in the doldrums after trial results from the Women’s Health Initiative trial showed combined HRT was associated with increased heart disease, stroke and breast cancer [[10/07/02b]]. Oral contraceptives too have not been spared negative publicity.

The IARC says there is a small increase in the risk of breast cancer amongst users of oral contraceptives, while the risk of cervical cancer increases with duration of use, and liver cancer is also more prevalent in long-term users. However, OCs decrease the chances of developing both endometrial and ovarian tumours.

For menopausal therapy, the risk of breast and endometrial tumours are raised and increase with duration of use, and there was no evidence to suggest HRT is protective at any site, says the IARC.

“This new information about cancer risks – and also protection against cancer in the case of OCs – makes it important that each woman who uses these hormonal products discusses the risks and benefits with her doctor, taking into consideration her personal circumstances and family history of cancer and other diseases.” It calls for rigourous analysis of the net effect of OCs on a country-by-country basis, because the overall health outcome may in fact be beneficial.