Q72: Women’s health: PLAB/UK(MLA)/AKT Exam style question
A 25-year-old woman comes to your clinic seeking advice on the potential long-term effects of the combined oral contraceptive pill (COCP) on her health. Which of the following types of cancer has a reduced incidence in women taking the COCP?
A. Breast cancer
B. Cervical cancer
C. Ovarian cancer
D. Lung cancer
E. Pancreatic cancer
Explanations
The correct answer is C.
The combined oral contraceptive pill (COCP) is a widely used method of contraception containing both estrogen and progestogen. While it is an effective and convenient method, it also has various health effects that can influence a woman's risk of developing certain types of cancer.
In the context of this PLAB 1 / UKMLA question, the COCP has been shown to have a protective effect against ovarian cancer (Option C). This effect is thought to be due to the suppression of ovulation, which reduces the number of times the ovarian epithelium is disrupted and repaired. The protective effect increases with the duration of use and persists for many years after discontinuation of the COCP.
It is essential to note that the COCP has other effects on cancer risk:
Increased risk of breast and cervical cancer: Women who take the COCP have a slightly increased risk of developing breast cancer and cervical cancer compared to those who do not. The risk of breast cancer decreases over time after stopping the pill, while the risk of cervical cancer is related to the duration of use.
Protective against endometrial cancer: Similar to its protective effect on ovarian cancer, the COCP also reduces the risk of endometrial cancer. This is likely due to the progestogen component, which opposes the proliferative effects of estrogen on the endometrium.
In summary, the COCP has a complex impact on a woman's risk of developing certain types of cancer. It is essential to counsel patients on these potential risks and benefits and help them make an informed decision about their contraceptive options.
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Reference:
Contraceptive services for under 25s | Guidance | NICE3: This is a public health guideline from NICE that provides recommendations on how to ensure that all young people have access to high-quality contraceptive services. It covers service design and delivery, information and advice, provision of methods, and training and education. It was published in March 2014.
Long-acting reversible contraception | Guidance | NICE4: This is a clinical guideline from NICE that covers long-acting reversible contraception (LARC) methods, such as intrauterine devices (IUDs), intrauterine systems (IUSs), contraceptive implants, and injectable contraceptives. It aims to increase the use of LARC by improving the information given to women about their contraceptive choices. It was published in October 2005.