Which of the following neoplasm has been associated with the use of oral contraceptives?

Appeared in: BHU NO - 2015

Explanation

Use of combined oral contraceptives (COCs) has been associated with an increased risk of developing benign hepatic adenomas, particularly with older, high-dose estrogen formulations.
Although these tumors are rare, they can lead to serious complications like rupture and hemorrhage, making this a clinically significant association.
Due to this risk, COCs are contraindicated in women with a known history of hepatic adenoma.

Option A: The link between COC use and breast cancer is not definitive; major studies show either no increased risk or a small, temporary risk in current users that declines after stopping.
Option B: COC use has a well-established protective effect, significantly lowering the long-term risk of developing ovarian cancer.
Option C: Similar to ovarian cancer, COC use provides a significant protective effect, reducing the incidence of endometrial cancer.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Association between oral contraceptives and neoplasms as background academic context rather than a clinical decision trigger.
Nurses must educate patients on both the risks and non-contraceptive benefits of OCs, including the reduced risk of ovarian and endometrial cancers.
A thorough patient history is crucial to screen for contraindications, such as a history of liver tumors, before initiating hormonal contraception.
What if? If a patient on OCs presents with sudden, severe right upper quadrant abdominal pain, a nurse should have a high index of suspicion for a ruptured hepatic adenoma, which is a medical emergency requiring immediate attention.

How to Approach the Question

First, identify the core of the question: which cancer is associated with oral contraceptive (OC) use.
This is a factual recall question that requires knowledge of the pharmacological effects and risks of OCs.
Systematically evaluate each option. Recall that OCs have a protective effect against some gynecological cancers.
Eliminate options known to have a reduced risk with OC use, such as ovarian and endometrial cancer.
Compare the remaining options. The link between OCs and breast cancer is debated and not as clear-cut as the known, albeit rare, association with hepatic adenomas.
Select the option with the most established positive association, which is hepatic adenoma.

Concept Tested & Keywords

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E6 Gynecology Williams p. 130-158

E6 Obstetrics Williams p. 82-95

Practise the full BHU NO - 2015

Attempt every question from this paper in a timed mock, then review the full solution for each one.