XXXX risks and the contraceptive pill. What is the evidence after nearly 25 years of use?

@entity1 @entity43 @entity778 @entity320 @entity0 @entity2735 @entity5 @entity189 @entity134 @entity65 @entity230 @entity105 @entity1558
The question of whether the steroidal components in oral contraceptives (OCs) may have an initiating or promotional influence on the development of @entity5 continues to be raised as a public health issue. It is estimated that since the introduction of OCs nearly 25 years ago, more than 150 million @entity1 have used 1 or more types of the formulation and nearly 1 billion @entity1 -years of exposure to the @entity230 have accumulated. Contraceptive practice in Australia would indicate that about 25% of @entity1 of reproductive age are using OCs. The debate about the OC's carcinogenic potential has recently been reopened with 2 reports in "The Lancet" of an association between the incidence of @entity0 and OC usage. Biologically the relationship between the contraceptive @entity230 and @entity5 must continue to be regarded as the most important concern with the longterm use of OCs. The demonstration of receptors to these steriods in these organs, in both normal and malignant tissues, further increases the speculation that the @entity134 hormones have a biological role in @entity105 in these target organs. Theoretical reasons exist for the concern about @entity105 and contraceptive @entity230 . This paper reviews the available evicence. Data can be derived only from large-scale epidemiological research, by means of case-control or cohort studies. No clear evidence exists that OCs cause or increase the chance of developing any @entity5 in the female genital tract and the breast. In fact, OC offers a significant protection against the development of @entity43 , especially to those @entity1 who have taken OCs for a long time. The association between the risk of @entity0 and OC use is less certain, but factors such as the history of @entity1558 , a close relationship with @entity0 , or nulliparity -- previously considered to be important -- do not appear to contribute significantly to the risk. The weight of evidence indicates that no increased risk of @entity0 exists, even in those younger @entity1 aged less than 25 years who decide to use OCs before their 1st full-term pregnancy. There is some evidence that suggests that the risk of cervical @entity5 , @entity2735 and @entity189 -- may increase slightly in OC users but the actual part played by the @entity1 's sexual history under these circumstances remains to be defined. There is now strong evidence to implicate multiplicity of @entity778 in @entity105 of the uterine cervix. There does not appear to be an overall relationship between OCs and @entity320 . Overall, the evidence is reassuring. The low-dose combined OC can be considered safe, not only in terms of @entity65 , but also in relation to @entity105 .
