Objectives:

To assess the relationship of long-term oral contraceptive use and exposure to sexually transmitted diseases to the risk of persistent gestational trophoblastic disease.

Methods:

This was a multicenter case-control study conducted in collaboration with gynecologic-oncologists at Northwestern University , Duke University , University of Minnesota , University of California at Irvine , M.D. Anderson Cancer Center , Yale University , and Brigham and Women's Hospital, Boston . Women age 18 through 44 who had been diagnosed with invasive hydatidiform mole or gestational choriocarcinoma were identified at the time of treatment. Their discharge summaries, pathology reports, and histologic slides were obtained and reviewed by an independent pathologist. For each case, two controls who were close to the case in age and who had a recent pregnancy were identified through the method of random-digit dialing.

Cases and controls were interviewed by telephone by a trained nurse-interviewer. The highly structured interview included a complete reproductive history, including questions on each episode of contraceptive use. It also included questions on sexual activity and history of a number of infectious diseases.

Results:

The relative risk estimate for ever having used oral contraceptives before the index pregnancy was 1.9 (95% confidence interval [CI] = 1.2-3.0), and the risk increased with duration of use (P for trend = .05). Separate analyses of choriocarcinoma and persistent mole yielded similar results, i.e., the relative risk estimates for oral contraceptive use were 2.2 (95% CI = 0.8-6.4) and 1.8 (95% CI = 1.0-3.0), respectively. Control for the number of sexual partners, which was independently associated with risk (P for trend = .05), did not materially change the results.

Investigators:

Julie Palmer, Sc.D., Principal Investigator
Lynn Rosenberg Sc.D., Co-Investigator
Samuel Shapiro, M.B., Co-Investigator

Source of funding:

National Cancer Institute

Study Period:

May 1, 1990 - April 30, 1995

Publications:

Link to Publications