Mortality associated with oral contraceptive use: 25 year follow up of cohort of 46 000 women from Royal College of General Practitioners' oral contraception study

Beral, Valerie; Hermon, C; Kay, Clifford R.; Hannaford, Philip Christopher; Darby, Sarah C.; Reeves, Gillian

doi:10.1136/bmj.318.7176.96

Cited by 212 publications

(108 citation statements)

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“…Similarly, no consistent pattern was evident for colon and rectal cancers. Only 2 studies (Fernandez et al, 1998;Beral et al, 1999) included information on recency of use, and there was some indication that the apparent protection was stronger for women who had used OCs more recently (RR = 0.46; 95% CI: 0.30-0.71). The Netherlands…”

Section: Resultsmentioning

confidence: 99%

“…A total of 20 papers was reviewed, including 6 from cohort (Chute et al, 1991;Bostick et al, 1994;Martinez et al, 1997;Troisi et al, 1997;Beral et al, 1999;van Wayenburg et al, 2000), and 14 from case-control investigations (Weiss et al, 1981;Potter and McMichael, 1983;Furner et al, 1989;Negri et al, 1989;Kune et al, 1990;Peters et al, 1990;Franceschi et al, 1991;Wu-Williams et al, 1991;Jacobs et al, 1994;Kampman et al, 1994;Fernandez et al, 1996;Kampman et al, 1997;Fernandez et al, 1998;Talamini et al, 1998). Among the cohort studies, only the more recent of the two papers from the Nurses' Health Study (Chute et al, 1991;Martinez et al, 1997) were considered.…”

Section: Methodsmentioning

confidence: 99%

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Oral contraceptives and colorectal cancer risk: a meta-analysis

et al. 2001

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Summary Several studies have suggested an inverse association between use of combined oral contraceptives (OC) and the risk of colorectal cancer and here we present a meta-analysis of published studies. Articles considered were epidemiological studies published as full papers in English up to June 2000 that included quantitative information on OC use. The pooled relative risks (RR) of colorectal cancer for ever OC use from the 8 case-control studies was 0.81 (95% confidence interval (CI): 0.69-0.94), and the pooled estimate from the 4 cohort studies was 0.84 (95% CI: 0.72-0.97). The pooled estimate from all studies combined was 0.82 (95% CI: 0.74-0.92), without apparent heterogeneity. Duration of use was not associated with a decrease in risk, but there was some indication that the apparent protection was stronger for women who had used OCs more recently (RR = 0.46; 95% CI: 0.30-0.71). A better understanding of this potential relation may help informed choice of contraception.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Oral contraceptives and colorectal cancer risk: a meta-analysis

et al. 2001

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“…That use of hormonal contraceptives (HC) may reduce the incidence of ovarian cancer is well established from both casecontrol (Weiss et al, 1981;Centers for Disease Control Cancer and Steroid Hormone Study, 1987; The WHO Collaborative Study of Neoplasia and Steroid Contraceptives, 1989;Franceschi et al, 1991;Whittemore et al, 1992;Siskind et al, 2000) and cohort studies (Ramcharan et al, 1980;Willett et al, 1981;Vessey et al, 1987;Beral et al, 1988Beral et al, , 1999Hankinson et al, 1995;Vessey and Painter, 1995), as recently reviewed (IARC Working Group, 1999;La Vecchia and Franceschi, 1999). Indeed, this benefit may be strong enough to reduce population-based incidence rates in places where HC have been used extensively (Adami et al, 1990;Parazzini et al, 2000;Walker et al, 2002).…”

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confidence: 99%

Risk for invasive and borderline epithelial ovarian neoplasias following use of hormonal contraceptives: the Norwegian–Swedish Women's Lifestyle and Health Cohort Study

et al. 2004

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The risk of ovarian epithelial neoplasia following use of hormonal contraceptives (HC) was examined in data from the NorwegianSwedish Women's Lifestyle and Health cohort including 103 551 women aged 30 -49 years in 1991 -92. Follow-up through 2000 produced 214 incident cases of histologically confirmed epithelial ovarian neoplasias (135 invasive and 79 borderline cases). Using the Cox proportional hazard models, ever having used HC was associated with a decreased relative risk of epithelial ovarian cancer of 0.6 (95% CI 0.5 -0.8). The effect of duration of HC use was convincing (P for trend o0.0001), and more important than age at start of use or time since first or last use. There was no significant difference between the effects of combined oral contraceptives and progestins-only contraceptives on risk (P ¼ 0.98). Similarly, there was no significant difference between the effects of ever use of HC on invasive and borderline ovarian neoplasia (P ¼ 0.37). In this cohort, use of HC seems to reduce the risk of epithelial ovarian neoplasia markedly and persistently in relation to the duration of use.

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“…2,8 -11 A few studies, however, have assessed the risk with longer time since last use. [12][13][14][15][16] A cohort analysis of ovarian cancer incidence and mortality rates in U.S. women over the period 1970 -1995 7 indicated that the relative decrease in incidence is greater before age 50. There is, therefore, a suggestion that the protection declines with time since last use, but the data are inconclusive.…”

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confidence: 99%

Long‐term effects of oral contraceptives on ovarian cancer risk

Bosetti

Negri

Trichopoulos³

et al. 2002

Intl Journal of Cancer

108

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Epidemiologic studies conducted since the late 1970s have reported a protective effect of oral contraceptives (OCs) from ovarian cancer and a stronger reduction of risk for longer duration of use. 1-3 An indication of a favorable impact of OC on ovarian carcinogenesis comes also from descriptive epidemiology. In several developed countries, young women have shown substantial decreases in incidence of and mortality from ovarian cancer, and the downward trends are greater in countries where OCs are widely used. 4 -7 However, there remain open issues on the relation between OC use and ovarian cancer, including a better quantification of timerelated factors, notably time since last use, age at first use and time since first use. Some of the studies that have considered time since last OC use have reported that the favorable effect of OCs on ovarian cancer risk persists for at least 15 years after stopping use. 2,8 -11 A few studies, however, have assessed the risk with longer time since last use. 12-16 A cohort analysis of ovarian cancer incidence and mortality rates in U.S. women over the period 1970 -1995 7 indicated that the relative decrease in incidence is greater before age 50. There is, therefore, a suggestion that the protection declines with time since last use, but the data are inconclusive. 2 In addition, few studies have simultaneously addressed all time factors, so the possibility of residual confounding in some of these studies cannot be excluded.To clarify the time relation between OC use and ovarian cancer risk, we conducted a collaborative reanalysis of European casecontrol studies of epithelial ovarian cancer. MATERIAL AND METHODSIn the present analysis, data from 6 case-control studies conducted in the United Kingdom, Greece and Italy were combined, i.e., all studies on OC and ovarian cancer published from Europe. The study design and methods have already been described. 12 Briefly, the first was a hospital-based investigation conducted in London and Oxford, UK, between 1978 and 1983. 17 Cases were 235 women under 65 years of age with epithelial ovarian cancer; controls were 451 women of comparable age, hospitalized for gastrointestinal diseases (23%), bone or joint diseases including fractures (22%) and a large number of other diagnostic categories, each including Ͻ10% of the total number of controls.The second study included 150 patients with malignant epithelial tumors of the ovary, admitted during 1980 and 1981 to 10 large hospitals of the Greater Athens area, Greece, 18 and 250 controls of similar age, hospitalized in the same time period in Athens hospitals for orthopedic conditions (among which 62% were traumas).The third study included 189 cases of epithelial ovarian cancer admitted to 2 major hospitals in Athens between 1989 and 1991. 19 Controls were 200 women, resident in the Greater Athens area, visitors of patients hospitalized in the same ward as cases in the same time period. Both cases and controls were below 75 years of age.The fourth study was a hospital-based investigatio...

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Mortality associated with oral contraceptive use: 25 year follow up of cohort of 46 000 women from Royal College of General Practitioners' oral contraception study

Cited by 212 publications

References 8 publications

Oral contraceptives and colorectal cancer risk: a meta-analysis

Oral contraceptives and colorectal cancer risk: a meta-analysis

Risk for invasive and borderline epithelial ovarian neoplasias following use of hormonal contraceptives: the Norwegian–Swedish Women's Lifestyle and Health Cohort Study

Long‐term effects of oral contraceptives on ovarian cancer risk

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