Marchbanks Polly A, McDonald Jill A, Wilson Hoyt G, Folger Suzanne G, Mandel Michele G, Daling Janet R, Bernstein Leslie, Malone Kathleen E, Ursin Giske, Strom Brian L, Norman Sandra A, Wingo Phyllis A, Burkman Ronald T, Berlin Jesse A, Simon Michael S, Spirtas Robert, Weiss Linda K
Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, USA.
N Engl J Med. 2002 Jun 27;346(26):2025-32. doi: 10.1056/NEJMoa013202.
It is uncertain whether the use of an oral contraceptive increases the risk of breast cancer later in life, when the incidence of breast cancer is increased. We conducted a population-based, case-control study to determine the risk of breast cancer among former and current users of oral contraceptives.
We interviewed women who were 35 to 64 years old. A total of 4575 women with breast cancer and 4682 controls were interviewed. Conditional logistic regression was used to calculate odds ratios as estimates of the relative risk (incidence-density ratios) of breast cancer.
The relative risk was 1.0 (95 percent confidence interval, 0.8 to 1.3) for women who were currently using oral contraceptives and 0.9 (95 percent confidence interval, 0.8 to 1.0) for those who had previously used them. The relative risk did not increase consistently with longer periods of use or with higher doses of estrogen. The results were similar among white and black women. Use of oral contraceptives by women with a family history of breast cancer was not associated with an increased risk of breast cancer, nor was the initiation of oral-contraceptive use at a young age.
Among women from 35 to 64 years of age, current or former oral-contraceptive use was not associated with a significantly increased risk of breast cancer.
口服避孕药的使用是否会增加日后患乳腺癌的风险尚不确定,而乳腺癌的发病率在日后会升高。我们开展了一项基于人群的病例对照研究,以确定口服避孕药的既往使用者和当前使用者患乳腺癌的风险。
我们对年龄在35至64岁之间的女性进行了访谈。共访谈了4575名乳腺癌女性患者和4682名对照者。采用条件逻辑回归计算比值比,作为乳腺癌相对风险(发病密度比)的估计值。
当前正在使用口服避孕药的女性,其相对风险为1.0(95%置信区间为0.8至1.3);既往使用过口服避孕药的女性,其相对风险为0.9(95%置信区间为0.8至1.0)。相对风险并未随着使用时间的延长或雌激素剂量的增加而持续升高。白种女性和黑种女性的结果相似。有乳腺癌家族史的女性使用口服避孕药与患乳腺癌风险增加无关,年轻时开始使用口服避孕药也与患乳腺癌风险增加无关。
在35至64岁的女性中,当前或既往使用口服避孕药与患乳腺癌风险显著增加无关。