Hepatocellular carcinoma and oral contraceptives.

Abstract

This article reports 11 new cases of liver cancer in US born women ages 18-39 occurring in 1975-80 obtained from the population-based cancer registry for Los Angeles County, California. 2 matched controls were obtained for each case. 10 cases had used OCs for periods ranging from 6-168 months, and 1 was given unspecified hormone shots for menstrual regulation during the 9 months preceding hormone shots for menstrual regulation during the 9 months preceding diagnosis of liver cancer. 6 were taking hormones at the time of diagnosis. The average duration of OC use among the 10 cases was 64.7 months compared with 27.1 months in controls (p0.005). Review of histopathologic material indicated that 3 cases had typical fibrolamellar carcinomas and 1 had a typical microtrabecullar carcinoma. 1 other case was a typical well-differentiated hepatocellular carcinoma. In 3 additional cases, the carcinoma was more undifferentiated but some trabecullar pattern was evident. The remaining 3 cases had distinctly unusual liver neoplasms, including a giant cell carcinoma, a sclerosing duct forming carcinoma, and a papillary carcinoma. The latter tumor occurred in a woman who had used OCs for 168 months. There was no evidence of exposure to other potential causes for liver cell carcinoma. The clinical, pathological, and epidemiological data strongly suggest that longterm OC use may cause hepatocellular carcinoma.