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Yaz (drospirenone-ethinyl estradiol)

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Yaz may cause cervical cancer.

Medical Source Information
Yellow highlights indicate symptoms related to cervical cancer.

Oncologic side effects related to oral contraceptive use have been studied extensively. A number of studies have examined a possible relationship between the use of oral contraceptives and the development of breast cancer. Many of the studies have reported conflicting results. A committee of the World Health Organization evaluated these studies and the risks of breast cancer and concluded that: "Numerous studies have found no overall association between oral contraceptive use and risk of breast cancer." In addition, the same committee also examined a possible relationship between oral contraceptive use and neoplasms of the uterine cervix and concluded that: "There are insufficient data to draw any firm conclusions regarding the effects of combined oral contraceptives on the risk of cervical adenocarcinoma".

The World Health Organization committee also noted that some studies "have found a weak association between long-term use of oral contraceptives and breast cancer diagnosed before the age of 36, and perhaps up to the age 45....It is unclear whether this observed association is attributable to bias, the development of new cases of cancer, or accelerated growth of existing cancers." The World Health Organization committee further concluded that there is no increased risk of breast cancer in women over the age of 45 who have previously taken oral contraceptives. In addition, studies suggest that use of oral contraceptives does not place specific groups of women (like those with a family history of breast cancer) at higher or lower risk, and variations in the hormonal content of oral contraceptives do not influence the risk of breast cancer. In general, studies evaluating the potential risk of cervical cancer in patients taking oral contraceptives have been complicated by the large number of confounding factors which make investigations into the epidemiology of this neoplasm difficult. Some studies have suggested that women taking oral contraceptives are at increased risk of dysplasia, epidermoid carcinoma, and adenocarcinoma of the cervix. However, other studies have not found such an association.

Side Effects to Watch
Watch closely for the following side effects and notify your physician immediately should any of these develop:
  • Abnormal bruising or signs of bleeding such as bleeding from the gums, nose, digestive tract, vagina (females), faintness, dizziness, loss of consciousness, or rash (signs of problems with blood clot formation)
Lab and Diagnostic Tests
If certain symptoms develop, ask your physician whether you need the following lab tests or other diagnostic tests (if you've not already had them):
  • Monitor estradiol, glucose and potassium
  • Blood tests to assess normal clotting - in people who develop signs of bleeding such as abnormal bruising or signs of bleeding including bleeding from the gums, nose, digestive tract, vagina (females), faintness, dizziness, loss of consciousness, or rash
References
  1. Prospective study of oral contraceptive use and risk of breast cancer in women. Romieu I, Willett WC, Colditz GA, Stampfer MJ, Rosner B, Hennekens CH, Speizer FE J Natl Cancer Inst 1989;81:1313-21.
  2. Female hormone utilisation and risk of hepatocellular carcinoma. Tavani A, Negri E, Parazzini F, Franceschi S, La Vecchia C Br J Cancer 1993;67:635-7.
  3. A case-control study of the risk of breast cancer in relation to oral contraceptive use. Rosenberg L, Palmer JR, Clarke EA, Shapiro S Am J Epidemiol 1992;136:1437-44.
  4. Benefits and risks of oral contraceptive use. Williams RS Postgrad Med 1992;92:155-7.
  5. Oral contraceptives and gynecologic cancer: an update for the 1990s. Kaunitz AM Am J Obstet Gynecol 1992;167:1171-6.
  6. Oral contraceptive use and mortality during 12 years of follow-up: the Nurses' Health Study. Colditz GA Ann Intern Med 1994;120:821-6.
  7. Contraception. Mishell DR N Engl J Med 1989;320:777-85.
  8. Association of focal nodular hyperplasia and hepatic hemangioma. Mathieu D, Zafrani ES, Anglade MC, Dhumeaux D Gastroenterology 1989;97:154-7.
  9. Oral contraceptive use and liver cancer. Palmer JR, Rosenberg L, Kaufman DW, Warshauer ME, Stolley P, Shapiro S Am J Epidemiol 1989;130:878-82.
  10. Oral contraceptives and breast cancer: a cooperative italian study. Lavecchia C, Negri E, Franceschi S, Talamini R, Amadori D, Filiberti R, Conti E, Montella M, Veronesi A, Parazzini F, Ferraroni M Int J Cancer 1995;60:163-7.
  11. Breast cancer before age 45 and oral contraceptive use: new findings. Miller DR, Rosenberg L, Kaufman DW, Stolley P, Warshauer ME, Shapiro S Am J Epidemiol 1989;129:269-80.
  12. Long-term health risks and benefits of oral contraceptive use. Peterson HB, Lee NC Obstet Gynecol Clin North Am 1990;17:775-88.
  13. Cervical adenocarcinoma in young women: possible relationship to microglandular hyperplasia and use of oral contraceptives. Jones MW, Silverberg SG Obstet Gynecol 1989;73:984-9.
  14. Breast cancer and hormonal contraceptives: further results. Calle EE, Heath CW, Miraclemcmahill HL, Coates RJ, Liff JM, Franceschi S, Talamini R, Chantarakul N, Koetsawang S, Rachawat D Contraception 1996;54 (suppl:s1-106.
  15. Oral contraceptives and breast cancer. A review with some comments on mathematical models. Lund E Acta Oncol 1992;31:183-6.
  16. A quantitative assessment of oral contraceptive use and risk of ovarian cancer. Hankinson SE, Colditz GA, Hunter DJ, Spencer TL, Rosner B, Stampfer MJ Obstet Gynecol 1992;80:708-14.
  17. Product Information. Yasmin (drospirenone-ethinyl estradiol) Anonymous Berlex Laboratories, Richmond, CA. PROD;
  18. Oral contraceptive-associated liver cell adenoma and hepatocellular carcinoma. Tao LC Cancer 1991;68:341-7.
  19. Patterns of research. Oral contraceptives and cervical cancer. Sillero-Arenas M, Rodriguez-Contreras R, Delgado-Rodriguez M, Bueno-Cavanillas A, Galvez-Vargas R Acta Obstet Gynecol Scand 1991;70:143-8.
  20. Oral contraceptives and breast cancer risk in Denmark. Ewertz M Eur J Cancer 1992;28A:1176-81.
  21. The estimated effect of oral contraceptive use on the cumulative risk of epithelial ovarian cancer. Gross TP, Schlesselman JJ Obstet Gynecol 1994;83:419-24.
  22. Oral contraceptives and neoplasia. WHO Scientific Group. Anonymous World Health Organ Tech Rep Ser 1992;817:1-46.
  23. Hepatic adenoma presenting as a right lower quadrant mass. Mooney MJ, Nyreen MR, Hall RA, Carter PL Am Surg 1993;59:229-31.
  24. The safety of oral contraceptives: epidemiologic insights from the first 30 years. Grimes DA Am J Obstet Gynecol 1992;166:1950-4.
  25. Oral contraceptives and breast cancer. Schlesselman JJ Am J Obstet Gynecol 1990;163:1379-87.
  26. Cancers related to contraceptive use. Rettig BA, Lemon HM Br J Cancer 1996;74:1509-10.
  27. Oral contraception: risks and benefits. Steinberg WM Adv Contracept 1989;5:219-28.
  28. Oral contraceptives and cervical neoplasia. Brinton LA Contraception 1991;43:581-95.
  29. Choosing the best oral contraceptive. Stubblefield PG Clin Obstet Gynecol 1989;32:316-28.
  30. Oral contraceptives and cervical cancer - further findings from the oxford family planning association contraceptive study. Zondervan KT, Carpenter LM, Painter R, Vessey MP Br J Cancer 1996;73:1291-7.
  31. Transformation of hepatic cell adenoma to hepatocellular carcinoma due to oral contraceptive use. Gyorffy EJ, Bredfeldt JE, Black WC Ann Intern Med 1989;110:489-90.
  32. Multicenter randomized comparative trial of two low-dose triphasic combined oral contraceptives containing desogestrel or norethindrone. Shoupe D Obstet Gynecol 1994;83:679-85.
  33. Benefits and risk of oral contraceptives. A reassessment. Burkman RT Jr J Reprod Med 1991;36:217-8.
  34. Early oral contraceptive use and breast cancer among premenopausal women: final report from a study in southern Sweden. Olsson H, Moller TR, Ranstam J J Natl Cancer Inst 1989;81:1000-4.
  35. Characteristics relating to ovarian cancer risk: collaborative analysis of seven U.S. case-control studies. Epithelial ovarian cancer in black women. Collaborative Ovarian Cancer Group. John EM, Whittemore AS, Harris R, Itnyre J J Natl Cancer Inst 1993;85:142-7.
  36. Oral contraceptives and breast cancer: review of the epidemiologic literature. Thomas DB Contraception 1991;43:597-642.
  37. Oral contraceptives and cancer of the cervix uteri. A meta-analysis. Delgado-Rodriguez M, Sillero-Arenas M, Martin-Moreno JM, Galvez-Vargas R Acta Obstet Gynecol Scand 1992;71:368-76.
  38. Oral contraceptive use and incidence of cervical intraepithelial neoplasia. Turnquest MA Am J Obstet Gynecol 1993;168:1895-6.
  39. Oral contraceptive use in women with a family history of breast cancer. Murray PP, Stadel BV, Schlesselman JJ Obstet Gynecol 1989;73:977-83.
  40. Oral contraceptives: a reassessment. Derman R Obstet Gynecol Surv 1989;44:662-8.
Multum version: 154.0 (Jun 16, 2010)
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