Delgado-Rodriguez M, Sillero-Arenas M, Rodriguez-Contreras R, López Gigosos R, Gàlvez Vargas R
Department of Preventive Medicine, School of Medicine, General Hospital Vigen de las Nieves, Granada, Spain.
Rev Epidemiol Sante Publique. 1991;39(2):165-81.
Since the relationship between oral contraceptive use and breast cancer has not been consistent we undertook a meta-analysis of studies published to date. Papers were located by searching the MEDLINE data base, supplemented by a hand search of all the references in the articles recovered. Studies were graded as to quality. Those judged as probably unbiased were included in the analysis. The method of Woolf was used to combine relative risks. Forty-seven studies were collected: 40 case-control and 7 cohort studies. Thirty-nine of these were considered unbiased. The main results observed were: RR was 1.06 (1.02-1.10) for all studies and 1.14 for premenopausal cancer. For premenopausal cancer, higher RRs were observed in women who early used oral contraceptives with a significant linear dose-response effect: 1.25 (1.10-1.44) in OC users before age 25, and 1.17 (1.06-1.30) in users before the first full-term pregnancy. We conclude oral contraceptive use may be a risk factor for premenopausal breast cancer. Limitations to our research are discussed.
由于口服避孕药的使用与乳腺癌之间的关系并不一致，我们对迄今发表的研究进行了一项荟萃分析。通过检索MEDLINE数据库查找相关论文，并对检索到的文章中的所有参考文献进行手工检索作为补充。对研究质量进行分级。那些被判定可能无偏倚的研究被纳入分析。采用伍尔夫方法合并相对风险。共收集到47项研究：40项病例对照研究和7项队列研究。其中39项被认为无偏倚。观察到的主要结果如下：所有研究的相对风险（RR）为1.06（1.02 - 1.10），绝经前癌症的RR为1.14。对于绝经前癌症，早期使用口服避孕药的女性观察到更高的RR，且存在显著的线性剂量反应效应：25岁之前开始使用口服避孕药的女性RR为1.25（1.10 - 1.44），首次足月妊娠前开始使用的女性RR为1.17（1.06 - 1.30）。我们得出结论，口服避孕药的使用可能是绝经前乳腺癌的一个风险因素。讨论了我们研究的局限性。
