Question

Use of oral contraceptive pills is known to protect against all of the following malignancies except:

• A. Ovarian carcinoma
• B. Endometrial carcinoma
• C. Uterine sarcoma
• D. Carcinoma cervix

Hint:

OCPs lower ovarian and endometrial cancer risk but do nothing against HPV driven cervical cancer.

Answer 1

The Correct Option is D

Oral contraceptive pills change the hormone environment of the reproductive tract, and this has different effects on different cancers. Let's go through each option.

1. Ovarian carcinoma: OCPs stop ovulation, which reduces the repeated trauma and repair of the ovarian surface that is thought to drive cancer here. Protective, so not the answer.
2. Endometrial carcinoma: the progestin component keeps the uterine lining thin and stops unopposed estrogen from driving overgrowth. Protective, so not the answer.
3. Uterine sarcoma: this tumour grows from the muscle wall, and OCPs are not known to lower its risk. Not protective, but the classic teaching point is really about the cervix below.
4. Carcinoma cervix: cervical cancer is driven by persistent HPV infection of the cervical cells. The pill has no action against the virus, so it gives no protection, and some data even show a small increase in risk with long term use.

Since the question asks which malignancy OCPs do NOT protect against among the standard teaching set (ovary and endometrium being the protected ones), the intended answer is carcinoma cervix.

Let's summarize:

• OCPs lower the risk of ovarian and endometrial cancer.
• OCPs give no protection against cervical cancer, which is an HPV driven disease.

So the malignancy not protected against is carcinoma of the cervix.