'Contraceptive pills driving fall in ovarian cancer deaths'

Widespread use of oral contraceptives is driving the fall in the number of deaths from ovarian cancer worldwide, according to a new study published today.

Deaths from ovarian cancer fell worldwide between 2002 and 2012 and are predicted to continue to decline in the US, European Union (EU) and, though to a smaller degree, in Japan by 2020, researchers said.

The main reason is the use of oral contraceptives and the long-term protection against ovarian cancer that they provide, said researchers, led by Professor Carlo La Vecchia from the University of Milan in Italy.

The decline in hormone replacement therapy (HRT) to manage menopausal symptoms and better diagnosis and treatment may also play a role, they said.

Using data on deaths from ovarian cancer from 1970 to the most recent available year from the World Health Organisation, the researchers found that in the 28 countries of the EU (minus Cyprus due to the unavailability of data) death rates decreased by 10 per cent between 2002 and 2012, from an age standardised death rate per 100,000 women of 5.76 to 5.19.

In the US the decline was even greater, with a 16 per cent drop in death rates from 5.76 per 100,000 in 2002 to 4.85 in 2012.

In Canada ovarian cancer death rates decreased over the same period by nearly 8 per cent from 5.42 to 4.95. In Japan, which has had a lower rate of ovarian cancer deaths than many other countries, the death rate fell by 2 per cent from 3.3 to 3.28 per 100,000, the study found.

Large decreases occurred in Australia and New Zealand between 2002 and 2011. In Australia the death rate declined by nearly 12 per cent from 4.84 to 4.27, and in New Zealand they dropped by 12 per cent from 5.61 to 4.93 per 100,000 women.

However, the pattern of decreases was inconsistent in some areas of the world, for instance in Latin American countries and in Europe, researchers said.

In European, the percentage decrease ranged from 0.6 per cent in Hungary to over 28 per cent in Estonia, while Bulgaria was the only European country to show an apparent increase.

In the UK, there was a 22 per cent decrease in death rates, which fell from 7.5 to 5.9 per 100,000 women. Other EU countries that had large decreases included Austria (18 per cent), Denmark (24 per cent) and Sweden (24 per cent).

The Latin American countries tended to have lower rates of deaths from ovarian cancer. Argentina, Chile and Uruguay showed decreases between 2002 and 2012, but Brazil, Colombia, Cuba, Mexico and Venezuela showed increases in death rates.

"The large variations in death rates between European countries have reduced since the 1990s when there was a threefold variation across Europe from 3.6 per 100,000 in Portugal to 9.3 in Denmark," La Vecchia said.

"This is likely to be due to more uniform use of oral contraceptives across the continent, as well as reproductive factors, such as how many children a woman has," said La Vecchia.

The research was published in the journal Annals of Oncology.