Which group of patients should avoid oral contraceptive pills due to contraindications?

The correct choice highlights that women over age 35 who smoke should avoid oral contraceptive pills due to significant health risks associated with their use. The primary concern in this demographic is the increased risk of thromboembolic events, such as deep vein thrombosis (DVT) and pulmonary embolism (PE). Estrogen-containing contraceptives can elevate the risk of these complications, particularly in women who smoke because smoking itself is a risk factor for clotting disorders and cardiovascular events.

Contrastingly, while age alone is a consideration for the use of oral contraceptives, the threshold of age 35 combined with smoking significantly amplifies the risks, warranting avoidance of such contraceptives. This precaution is particularly emphasized in clinical guidelines due to the substantial evidence linking the combination of age and smoking to increased cardiovascular risks when using hormonal contraception.

In the other groups, while there may be radiological or anecdotal concerns, they do not carry the same level of contraindication as smoking in women over 35. For example, non-smokers over age 40 are generally considered to be at less risk compared to smokers, while women under age 30 with a family history of cancer do not necessarily have a blanket contraindication, nor do those with