Risk of Cancer and the Oral Contraceptive Pill

Full assessment of the risk of cancer needs a long follow-up as effects of the pill may persist many years after its use has been stopped. Between 1968 and 1969, 45 950 women in the United Kingdom were enrolled in the study, and they were followed for a mean of 24 years. Incidence rates of cancer in women who ever used the pill were compared with rates in women who never used the pill. On balance, no higher risk of cancer was found in pill users. Risks were significantly lower for cancer of the colon or rectum, uterine body, or ovaries; the main gynaecological cancers combined (uterine body, ovaries, cervix); and for any diagnosis of cancer. The incidence of breast cancer was similar in pill users and never users. The results show that—in a developed country with an effective cervical cancer screening programme such as the UK—the pill is a safe contraceptive method with respect to cancer. In some developing countries—with inadequate cervical cancer screening and healthcare services, and high cervical cancer rates—the balance of cancer risk is probably less favourable.However, in such settings, contraceptive benefits must be weighed against the risk of cervical cancer, and the balance would tilt in favour of the pill because of the high morbidity and mortality associated with unplanned pregnancies.
Hannaford et. al., BMJ 2007 335: 651.

Sex Education Programmes 'not working': Rate of Casual Sex High but Condom Use is Low

Malta needed an "urgent re-appraisal" of its sex education and health promotion programmes, because year after year no improvement was being registered, warned Dr. Carabot, who runs the Genitourinary Clinic. Sexually transmitted diseases are steadily on the rise. In 2006, there were 10 cases of HIV (up from two cases in 2000), and gonorrhoea shot up to 32 cases (from 23 in 2005). The vast majority (on average 70 per cent) of GU clinic users never used contraception. Last year, 1,946 people attended the clinic, with 70 per cent of these being new patients. The report shows that 46 per cent described their partner as casual, while 67 per cent never used a condom. "This pattern of high casual sex with very poor condom use is persistent through the years. We must eventually recognise that our sex education and sexual health promotion efforts are simply not adequate and are not giving any positive results," the report said.

An Audit of Natural Family Planning and Usage

The Cana Movement has been training couples in Natural Family Planning (NFP) methods for a number of years, in its efforts to support and to strengthen the Maltese family. J. Mizzi and colleagues conducted an audit to evaluate this education programme, including current use and perception of NFP methods. An anonymous postal survey was carried out among all those who took part in NFP courses between 1995 and 2004. Results are compared to data drawn from the Health Interview Survey (HIS) carried out by the Department of Health Information in 2002 on a representative sample of the Maltese population. The great majority of the NFP respondent population (62%) had been married for 5 to 10 years, and were mostly between 30 and 35 years. A large group of female respondents described themselves as housewives (49%). All women had achieved at least secondary education. The top two occupational groups among male respondents were professionals (20%) and skilled labourers (19%). 57% found NFP methods to be very reliable. This proportion peaks to 75% among 40-45 year old women. HIS figures show the three most popular family planning methods among 16 to 25 year olds and 26 to 35 year olds are NFP, condoms and withdrawal, with the latter method being the most popular in the older age group and condoms being preferred by the younger group. J. Mizzi et al Malta Medical Journal 15 Issue 1-2/suppl. (2003)