Oral contraceptive use and mortality after 36 years of follow-up in the Nurses’ Health Study: prospective cohort study
作者： B. M. Charlton , J. W. Rich-Edwards , G. A. Colditz , S. A. Missmer , B. A. Rosner
DOI: 10.1136/BMJ.G6356
关键词: Cause of death 、 Pediatrics 、 Population 、 Gynecology 、 Proportional hazards model 、 Prospective cohort study 、 Hazard ratio 、 Family planning 、 Medicine 、 Nurses' Health Study 、 Relative risk
摘要: Objective To determine whether use of oral contraceptives is associated with all cause and specific mortality. Design Prospective cohort study. Setting Nurses’ Health Study, data collected between 1976 2012. Population 121 701 participants were prospectively followed for 36 years; lifetime contraceptive was recorded biennially from to 1982. Main outcome measures Overall mortality, assessed throughout follow-up until Cox proportional hazards models used calculate the relative risks mortality contraceptives. Results In our population 577 women information on use, 63 626 never users (52%) 57 951 ever (48%). After 3.6 million person years, we 31 286 deaths. No association observed However, violent or accidental deaths more common among (hazard ratio 1.20, 95% confidence interval 1.04 1.37). Longer duration strongly certain causes death, including premature due breast cancer (test trend P Conclusions All did not differ significantly who had users. Oral increased rates death cancer, whereas ovarian less These results pertain earlier formulations higher hormone doses rather than now commonly third fourth generation lower estrogen doses.
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