Zoricić D, Ambrozić B, Perić D
Djelatnost za ginekologiju i porodnistvo, Opća bolnica Pula.
Lijec Vjesn. 1998 Dec;120(12):392-7.
Hormonal contraception is important for the way of life of many modern women. Since the oral contraceptives were introduced 30 years ago, millions of women were using the pill and large number of experimental, clinical and epidemiological studies have analyzed the risks of their administration. The question whether the usage of exogenous sex-steroids as hormonal contraception may favor the development of breast malignancy is a much debated problem, but a complete answer to the question of the relationship between contraception pill and breast cancer is at present still unresolved. Most studies have not found an overall increased risk of breast cancer associated with the use of the pill, but several recent studies suggested a link between the early-onset breast cancer and a long-term use of oral contraceptives at young ages. The risks for some subpopulations of women seem small (relative risk about 2.0 or less), but consistency of the findings has enforced further study. Women under the age of 35, if they have used the pill long-term or if they are at increased risk of breast cancer for other reasons, should discuss the risks of oral contraceptive use. Contraindications of pill usage must be strictly respected and their users carefully watched, including routine breast examinations. It is equally important to inform our patients about important and numerous positive impacts of pill usage on women's health, to reassure these women and prevent cancerophobia. Sufficient time has now elapsed to permit prospective epidemiological studies with large numbers of women who took the pill for many years beginning at a young age, and follow them as they come in age when breast cancer is most common. So we should carefully examine their results.
激素避孕对许多现代女性的生活方式很重要。自从30年前口服避孕药问世以来,数百万女性一直在使用避孕药,大量的实验、临床和流行病学研究分析了服用避孕药的风险。使用外源性性类固醇作为激素避孕是否会促进乳腺恶性肿瘤的发展是一个备受争议的问题,但目前关于避孕药与乳腺癌之间关系问题的完整答案仍未解决。大多数研究并未发现服用避孕药会使乳腺癌的总体风险增加,但最近的几项研究表明,早发性乳腺癌与年轻时长期使用口服避孕药之间存在联系。某些女性亚群体的风险似乎较小(相对风险约为2.0或更低),但研究结果的一致性促使进一步研究。35岁以下的女性,如果长期服用避孕药或因其他原因患乳腺癌的风险增加,应该讨论使用口服避孕药的风险。必须严格遵守避孕药使用的禁忌症,并仔细观察使用者,包括进行常规乳房检查。同样重要的是,要告知我们的患者避孕药对女性健康的重要且众多的积极影响,让这些女性安心并预防恐癌症。现在已经过去了足够长的时间,可以对大量从年轻时就开始服用避孕药多年的女性进行前瞻性流行病学研究,并在她们进入乳腺癌最常见的年龄阶段时对其进行跟踪。所以我们应该仔细研究它们的结果。