Ovarian cancer mortality rate

Data from the classic Nurses Health Study, followed up in 1994, reflected no difference in all-cause mortality between women who had ever used oral contraceptives and those who had never used them (7). There was also no increase in mortality associated with duration of use and no relation with time since first use or time since last use. Similarly, in the OFPA (Oxford) study, the overall 20-year mortality risk for oral contraceptive users compared with women using diaphragms or IUCDs was 0.9, suggesting no effect (8). Although the number of deaths from each cause was small, the pattern is consistent with the risks found in other studies. Oral contraceptive users had somewhat higher death rates from ischemic heart disease and cervical cancer, but lower rates of ovarian cancer mortality. Breast cancer mortality was similar for oral contraceptive users and non-users. 

Any consideration of major issues relating to the balance of benefit and harm, such as cancer or mortality rates, should be supplemented by a consideration of less prominent ones, for example, a reduction in disorders of the menstrual cycle (such as dysmenorrhea, menorrhagia, and the premenstrual syndrome) and the reduced risks of iron deficiency anemia, functional ovarian cysts, uterine fibroids, benign breast disease, pelvic inflammatory disease, and ectopic pregnancy (10,11). 

A prospective American Cancer Society study found an increase in the mortality rates for colorectal and prostate cancer in overweight men and for endometrial, gallbladder, cervical, ovarian and breast cancer in overweight women (Lew 1985). An association with obesity is now firmly established for breast cancer in post-menopausal women, as well as for endometrial cancer and for renal cell cancer. Obesity may also play a part in the pathogenesis of colorectal, prostatic and pancreatic cancers in men (Caroll 1998). 

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