§ Jim Dobbin
To ask the Secretary of State for Health if he will make a statement on links between long-term use of the contraceptive pill and cervical cancer. 310W
§ Ms Blears
An association between long-term use of oral contraceptives (OCs) and a slightly increased risk of cervical cancer has been recognised for many years. However, it has not been possible to demonstrate a direct causal relationship as the presence of other factors, such as persistent infection with human papilloma virus (HPV), that are believed to have an important role in the development of cervical cancer, are also associated with long-term use of OCs.
A review of all eligible research on the long-term use of OCs and risk of cervical cancer has recently been published (The Lancet—5 April 2003–361:1159). This review took into consideration many other relevant factors, such as HPV infection and still found that use of OCs for many years is associated with a slight increase in the risk of cervical cancer compared with 'never-use'. A copy is available in the Library.
The Committee on Safety of Medicines (CSM) has kept the issue under review and has considered the latest evidence. CSM has advised that, as it is not possible to be certain that all relevant factors, such as duration of HPV infection, have been fully taken into account in the review, a definite causal relationship has yet to be established. Nonetheless, the new study strengthens the evidence for a causal link between long-term OC use and cervical cancer and research is ongoing.
Warnings about the risk of cervical cancer with long-term use have been included in the summary of product characteristics for health professionals and the patient information leaflet for women for many years. In addition, women are advised to regularly attend for a cervical smear in accordance with Guidelines. In the United Kingdom, the introduction of a highly effective screening programme means that the total number of cases of cervical cancer is low and mortality has fallen.