Possible Cervical Cancer & Birth Control Pills

Hi.  I've already had invasive tongue cancer (Stage 2) about 20 months ago that was presumed to be caused by HPV as I was only 29 at the time and no risk factors.  Now, I've had two abnormal paps and have tested positive for high risk HPV for over a year (but likely had to have acquired it over 3 years ago).  The first pap done after my diagnosis with tongue cancer was normal but HPV+ (only performed b/c the tongue cancer was suspected to be caused by HPV and there is no test for it in the oral cavity), the second 6 months later, was reactive changes but HPV neg (which we are thinking is lab error) and the third (another 6 months) was ASC-US and again HPV+.  I am having colposcopy performed in a few weeks and hopefully it will be very early changes if anything and not yet cancer.  

I've been on the pill for 13 years now - only going off for a few weeks when I had the tongue cancer tumor removed (I did not have radiation or chemo).  I've read a little that suggests being on birth control so long will increase my risk of developing cervical cancer due to my HPV status by as much as 4 times increased.  Is this still believed to be true across the GYN community?

I know that normally HPV caused cervical cancer takes years to develop - but my tongue cancer did not - so I am scared to death that the cervical will already be a carcinoma as well.  Also - my body is obviously not clearing the virus as I have to have acquired it over 3 years ago at a minimum - but could have been much earlier than that.

Any advice if it does turn out to be CIN or higher?  

[Keith Downing, MD]

Hello,

I'm glad to hear you have recovered well from the tongue cancer surgery, and wish you continued good health and well being.  

The reason for the association of OCP use and cervical cancer is unclear.  I suggest you talk with your gyn about the risks/benefits of cervical cancer vs. pregnancy and decide whether you want to continue the pill or try an alternative for of contraception.  

Lastly, I'd recommend close follow up with regular colposcopic evaluations until otherwise indicated.  
It sounds as if you are getting good care.  

Best regards,

Dr. Downing