Fasal E, Paffenbarger R S
J Natl Cancer Inst. 1975 Oct;55(4):767-73. doi: 10.1093/jnci/55.4.767.
We conducted a case-control study to search for any relationship between use of oral contraceptives and development of breast cancer or benign breast disease. Women less than 50 years old with these diseases were matched with 2 controls by age, race, religion, and hospital. Home interviews elicited information on oral contraceptive use and other host and environmental factors. The study population comprised 1,770 women, including 452 with breast cancer and 446 with benign breast disease. The relative risk of developing cancer or benign disease was measured by matched set and summary chi-square analyses. Although the relative risk of developing breast cancer among "ever-users" of oral contraceptives was 1.1, the risk among women using oral contraceptives for 2-4 years was 1.9 (significantly increased). This risk estimate reached 2.5 for the 2- to 4-year users if they were still taking oral contraceptives when entered into study. Moreover, prior biopsy for benign breast disease increased the cancer risk among long-term users by as much as 11-fold. The relative risk of breast cancer did not vary by age, interval since first use, earliest year of use, or interval since last use. These results could be interpreted to indicate that oral contraceptives did not induce breast cancer but may have accelerated the growth rate of preexisting breast cancer. The relative risk of developing benign breast disease among ever-users of oral contraceptives was 0.8 (significantly reduced); it decreased with longer duration of use until it reached 0.2 for women who took these hormones 8 years or more. The relative risk of benign breast was not affected by earliest year of use or interval since last use. We concluded that oral contraceptives reduced the incidence of benign breast disease, but that use of steroid hormones is ill-advised for women with already established benign breast disease.
我们开展了一项病例对照研究,以探寻口服避孕药的使用与乳腺癌或乳腺良性疾病发生之间的关系。年龄小于50岁的患有这些疾病的女性与两名对照者按年龄、种族、宗教信仰和就诊医院进行匹配。通过家庭访谈获取有关口服避孕药使用情况以及其他宿主和环境因素的信息。研究人群包括1770名女性,其中452名患有乳腺癌,446名患有乳腺良性疾病。通过匹配组和汇总卡方分析来测量患癌症或良性疾病的相对风险。虽然口服避孕药“曾经使用者”患乳腺癌的相对风险为1.1,但口服避孕药2至4年的女性患癌风险为1.9(显著增加)。如果2至4年使用者在进入研究时仍在服用口服避孕药,那么该风险估计值达到2.5。此外,既往乳腺良性疾病活检使长期使用者的患癌风险增加多达11倍。乳腺癌的相对风险并不因年龄、首次使用后的间隔时间、最早使用年份或末次使用后的间隔时间而有所不同。这些结果可以解释为表明口服避孕药不会诱发乳腺癌,但可能加速了已存在的乳腺癌的生长速度。口服避孕药“曾经使用者”患乳腺良性疾病的相对风险为0.8(显著降低);随着使用时间延长,该风险降低,服用这些激素8年或更长时间的女性该风险降至0.2。乳腺良性疾病的相对风险不受最早使用年份或末次使用后的间隔时间的影响。我们得出结论,口服避孕药降低了乳腺良性疾病的发病率,但对于已患有乳腺良性疾病的女性,不建议使用甾体激素。