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A prospective study of oral contraceptive use and colorectal adenomas



The influence of reproductive factors on colorectal cancer, including oral contraceptive (OC) use, has been examined, but less research is available on OC use and adenomas.


Participants of the Nurses’ Health Study who had a lower bowel endoscopy between 1986 (when endoscopies were first assessed) and 2008 were included in this study. Multivariable logistic regression models for clustered data were used to estimate odds ratios and 95 % confidence intervals [OR (95 % CIs)].


Among 73,058 participants, 51 % (n = 37,382) reported ever using OCs. Ever OC use was associated with a slight increase in non-advanced adenomas [OR 1.11, 95 % CI (1.02, 1.21)] but not with any other endpoints. Duration of OC use was not associated with adenomas, but longer times since last OC use were associated with increased odds of adenomas [e.g., compared to never use, 15+ years since last use: OR 1.17 (1.07, 1.27)]. Shorter times since last OC use were inversely associated [e.g., ≤4 years since last use: OR 0.74 (0.65, 0.84)].


We observed a modest borderline increase in risk of colorectal adenomas with any prior OC use. Additionally, more recent OC use may decrease risk, while exposure in the distant past may modestly increase risk of adenomas.

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The NHS was supported by research Grants UM1CA186107 and P01CA87969 of the National Institutes of Health. BMC was supported by the Training Programs in Cancer Epidemiology (T32CA09001) from the National Cancer Institute and in Reproductive, Perinatal, and Pediatric Epidemiology (T32HD060454) as well as Grant F32HD084000 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health. WW was supported by Entertainment Foundation National Colon Cancer Research Alliance. An abstract of this work was presented at the Association for Cancer Research Annual Meeting on 7 April 2014 and the Society for Epidemiologic Research Annual Conference on 26 June 2014. We would like to thank the participants and staff of the Nurses’ Health Study for their valuable contributions as well as the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, WY. The authors assume full responsibility for analyses and interpretation of these data. Also, special thanks to Scott Smith for his programming assistance.

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Correspondence to Brittany M. Charlton.

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The authors declare that they have no conflict of interest.

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Return of the questionnaires was considered informed consent.

Research involving human participants

The study was approved by the Institutional Review Board of Brigham and Women’s Hospital in Boston.

Additional information

Kana Wu and Karin B. Michels have contributed equally to this work.

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Charlton, B.M., Giovannucci, E., Fuchs, C.S. et al. A prospective study of oral contraceptive use and colorectal adenomas. Cancer Causes Control 27, 749–757 (2016). https://doi.org/10.1007/s10552-016-0752-3

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  • Adenoma
  • Colorectal neoplasms
  • Contraceptives
  • Oral
  • Intestinal polyps
  • Reproductive history