Oral Contraceptives Use and Colorectal Cancer Risk Among Moroccan Women: A Case-Control Study

Colorectal cancer (CRC) encompasses both non-modifiable and modifiable risk factors. While diet remains the main factor influencing CRC risk, hormonal and reproductive factors have also demonstrated a potential impact on CRC risk. This study aims to explore the relationship between oral contraceptives (OC) use and Colorectal cancer risk among Moroccan women.

We conducted a case-control study included 300 participants, divided into 150 cases and 150 controls matched by age (± 3 years). Through a face-to-face interview with trained investigators, we collected data on oral contraceptives use among participants. we performed conditional logistic regression to estimate Odds Ratio (OR) and 95% confidence interval (95% CI), to elaborate a basic model and adjusted model for confounding factors to assess the relationship between OC use and CRC risk.

An inverse correlation was observed between OC use and CRC risk with OR²:0.57 (0.36-0.92), using OC at younger ages (≤24 years) for a longer period (>8 years) was also associated with a decreased risk of CRC, with OR²: 0.52 (0.31-0.89) and OR²: 0.43 (0.26-0.79), respectively. this association was consistent across all tumor location in the adjusted model, with OR²: 0.54 (0.27-0.98) for colon cancer, OR²: 0.47 (0.21-0.96) for rectal cancer, and OR²: 0.35 (0.12-0.9) for colorectal cancer. Furthermore, combined oral contraceptives use significantly reduced CRC risk, with OR²: 0.42 (0.21-0.75), whereas no significant reduction was observed with progestin-only pills with OR²: 0.64 (0.32-1.17).

These findings underscore the potential role of reproductive and hormone factors, such as oral contraceptive use, in reducing colorectal cancer risk, particularly for combined oral contraceptives initiated in a younger age, also the importance of incorporating reproductive and hormone factors in future research in Morocco, providing a broader understanding of colorectal cancer prevention strategies.