Kahlenborn Chris, Modugno Francesmary, Potter Douglas M, Severs Walter B
Department of Internal Medicine, Altoona Hospital, Altoona, PA, USA.
Mayo Clin Proc. 2006 Oct;81(10):1290-302. doi: 10.4065/81.10.1290.
To perform a meta-analysis of case-control studies that addressed whether prior oral contraceptive (OC) use is associated with premenopausal breast cancer.
We searched the MEDLINE and PubMed databases and bibliography reviews to identify case-control studies of OCs and premenopausal breast cancer published in or after 1980. Search terms used included breast neoplasms, oral contraceptives, contraceptive agents, and case-control studies. Studies reported in all languages were included. Thirty-four studies were identified that met inclusion criteria. Two reviewers extracted data from original research articles or additional data provided by study authors. We used the DerSimonian-Laird method to compute pooled odds ratios (ORs) and confidence intervals (CIs) and the Mantel-Haenszel test to assess association between OC use and cancer.
Use of OCs was associated with an increased risk of premenopausal breast cancer in general (OR, 1.19; 95% CI, 1.09-1.29) and across various patterns of OC use. Among studies that provided data on nulliparous and parous women separately, OC use was associated with breast cancer risk in both parous (OR, 1.29; 95% CI, 1.20-1.40) and nulliparous (OR, 1.24; 95% CI, 0.92-1.67) women. Longer duration of use did not substantially alter risk in nulliparous women (OR, 1.29; 95% CI, 0.85-1.96). Among parous women, the association was stronger when OCs were used before first full-term pregnancy (FFTP) (OR, 1.44; 95% CI, 1.28-1.62) than after FFTP (OR, 1.15; 95% CI, 1.06-1.26). The association between OC use and breast cancer risk was greatest for parous women who used OCs 4 or more years before FFTP (OR, 1.52; 95% CI, 1.26-1.82).
Use of OCs is associated with an increased risk of premenopausal breast cancer, especially with use before FFTP in parous women.
对探讨既往口服避孕药（OC）使用与绝经前乳腺癌之间是否存在关联的病例对照研究进行荟萃分析。
我们检索了MEDLINE和PubMed数据库以及文献综述，以确定1980年及以后发表的关于OC与绝经前乳腺癌的病例对照研究。使用的检索词包括乳腺肿瘤、口服避孕药、避孕剂和病例对照研究。纳入所有语言报道的研究。共识别出34项符合纳入标准的研究。两名审阅者从原始研究文章或研究作者提供的补充数据中提取数据。我们使用DerSimonian-Laird方法计算合并比值比（OR）和置信区间（CI），并使用Mantel-Haenszel检验评估OC使用与癌症之间的关联。
总体而言，使用OC与绝经前乳腺癌风险增加相关（OR，1.19；95%CI，1.09 - 1.29），且在各种OC使用模式中均如此。在分别提供未生育和已生育女性数据的研究中，使用OC与已生育女性（OR，1.29；95%CI，1.20 - 1.40）和未生育女性（OR，1.24；95%CI，0.92 - 1.67）的乳腺癌风险均相关。使用时间延长对未生育女性的风险影响不大（OR，1.29；95%CI，0.85 - 1.96）。在已生育女性中，首次足月妊娠（FFTP）前使用OC时的关联（OR，1.44；95%CI，1.28 - 1.62）比FFTP后使用时更强（OR，1.15；95%CI，1.06 - 1.26）。对于在FFTP前4年或更长时间使用OC的已生育女性，OC使用与乳腺癌风险之间的关联最大（OR，1.52；95%CI，1.26 - 1.82）。
使用OC与绝经前乳腺癌风险增加相关，尤其是已生育女性在FFTP前使用时。
