Are current oral contraceptives associated with an increased risk of liver tumors?.

Early oral contraceptives combining a high dose of ethinylestradiol with a progestogen responsible for marked androgenic effects have been shown to increase the risk of liver adenoma and to a lesser extent of hepatocellular carcinoma, and have also been suggested as a risk factor for focal nodular hyperplasia. To date, there have been no reports of studies specifically designed to evaluate the risk of liver tumors with current oral contraceptives combining a low dose of ethinylestradiol with a third-generation progestogen. No cases of liver tumor were identified in two retrospective studies conducted in Sweden from 1965 to 1994 in patients under contraceptives containing small amounts of ethinylestradiol or in a retrospective study done in Germany from 1971 to 1994 in patients taking oral contraceptives containing a third-generation progestogen. The natural estrogens used as menopausal replacement therapy do not increase the risk of liver tumors and may even protect against the occurrence of hepatocellular carcinoma.