IARC monographs program on carcinogenicity of combined hormonal contraceptives and menopausal therapy

Our plain-English summary of IARC monographs program on carcinogenicity of combined hormonal contraceptives and menopausal therapy, by H.P. Schneider, A.O. Mueck, H. Kuhl (Climacteric, 2005).

The study

• Authors: H.P. Schneider, A.O. Mueck, H. Kuhl
• Journal: Climacteric
• Published: 2005;8(4):311-6
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The World Health Organization International Agency for Research and Cancer (IARC), in June 2005, has classified combination hormone contraception and menopausal therapy as carcinogenic in humans. The IARC's distinction is to identify potential carcinogens associated with nutrition, environment and pharmaceutical products. They do not produce risk-benefit analyses for any country or population. Their conclusions are highly controversial in that no proof is presented for a causal relation of estrogens with reproductive cancer, be it plausibility according to mechanisms of action or experimental evidence in the animal model. Equating natural compounds like estradiol with defined carcinogens like asbestos, tobacco smoke as well as indispensable drugs such as aspirin and tamoxifen is of no substantial clinical relevance. Thus, there are no new reasons to change current management principles with combination hormone contraception and therapy.

In plain English

This article was not a research study. It was a commentary, labeled a "Presidential comment," by the president of the International Menopause Society written with two colleagues. It responded to the June 2005 decision of a working group of the World Health Organization's International Agency for Research on Cancer (IARC) to classify combined oral contraceptives and combined estrogen–progestagen menopausal hormone therapy as carcinogenic in humans (group 1). The article is not about asbestos. Asbestos is mentioned only as an example of a recognized carcinogen. The authors argued that the new IARC assessment of breast cancer risk with combined contraception was based on almost the same data as earlier assessments. They also argued that it had not been proven that hormone effects on breast cells lead to cancer. They called it highly controversial that natural compounds such as estradiol would be grouped with asbestos or tobacco smoke as carcinogenic. The authors concluded that there were no new reasons to change current management of oral contraception and menopausal hormone therapy. They noted that they were responding to an IARC press statement and short communication, before the full Monograph was published.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: commentary ("Presidential comment"), not an original study
• Who was studied: No people were studied. The article discusses the assessment made by the IARC Monograph Working Group, which met in Lyon, France, in June 2005.
• Exposure: Combined oral contraceptives and combined estrogen–progestagen menopausal hormone therapy. Asbestos is mentioned only as a comparison and is not studied.
• Main results:
  • The authors argued that the new IARC assessment of breast cancer risk with combined contraception, drawn from 60 studies of 60 000 patients, rested on almost the same data as the earlier assessments.
  • The authors argued it had not been proven that hormone-driven growth of normal breast cells causes cancer.
  • The authors objected that the classification grouped natural compounds such as estradiol with asbestos or tobacco smoke as carcinogenic, and called this highly controversial.
• The authors' conclusion: The authors concluded there were no new reasons to change current management of oral contraception and menopausal hormone therapy.
• Limitations the authors state:
  • The authors noted that they were responding to the IARC press statement and short communication, and that the full Monograph might disclose more details.

Topics

Medical terms in this study, explained in our Lexicon: IARC, Carcinogenic.

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