More research on the pill and alternative methods (of contraception)

More research on the pill and alternative methods of contraception was urged by Ralph Nader's Health Research Group (HRG), which also recommended that the Food and Drug Administration develop a new patient package insert for all forms of contraceptives, including nonprescription methods. The group also said the government and drug companies should share the cost of long-term follow-up studies of the effects on health of the pill and other birth control methods. The recommendations followed presentations at an HRG forum from NIH scientists and S. Ramcharan, principal investigator of the Walnut Creek (California) Contraceptive Study supported by the National Institute of Child Health and Human Development. Ramcharan studied 15,000 women over 10 years and found cervical cancer incidence of 173/100,000 person years for women who used the pill for more than 4 years, compared with a rate of 32/100,000 for women who never used the pill. Ramcharan declined to draw any cause-effect conclusions based on these results, stating they were "confounded" by possible differences in sexual activity between the 2 groups. She said a preliminary case comparison study to adjust for these differences "suggests sexual behavior may account for some, but not all," of the 5-fold increase in cervical cancer incidence among pill users. HRG director S. Wolfe said enough data exists to state a relationship between the pill and cervical cancer. "There's no other explanation for the increase," he said, adding that Ramcharan had controlled for the effects of age, education, marital status, number of Papanicolaou smears, religion, number of pregnancies, a history of genital infections, and smoking. Forum participants urged more research on contraceptive devices and drugs now in use, long-term effects of sterilization, value of condoms and spermicides in preventing VD, and development of a patient package insert for all forms of contraception stating the relative effectiveness and risks of each. The group discussed the need for long-term funding of follow-up studies, and suggested that drug companies be required to pay for at least some of the pre- and postmarketing research.