Unit of Health Care Epidemiology, University of Oxford, Oxford, UK.
Contraception. 2010 Sep;82(3):221-9. doi: 10.1016/j.contraception.2010.04.006. Epub 2010 May 18.
This analysis updates mortality in the Oxford-Family Planning Association (Oxford-FPA) contraceptive study, with emphasis on oral contraceptive (OC) use.
The Oxford-FPA study includes 17,032 women recruited from 1968-1974 at contraceptive clinics, aged 25-39 years, using OCs a diaphragm or an intrauterine device. Follow-up has been to March 2009; by then, 1715 women had died.
The rate ratio (RR) for overall mortality was 0.87 (CI 0.79-0.96), comparing ever-users of OCs with never-users. The RR for fatal cervical cancer was increased (7.3), but the CIs were very wide (1.2-305). There was no association between ever-use of OCs and mortality from breast cancer (RR 1.0, CI 0.8-1.2), nor was fatal breast cancer related to duration of OC use. OC use strongly protected against death from other uterine cancer and ovarian cancer; RRs for ever-use of OCs were 0.3 (CI 0.1-0.8) and 0.4 (CI 0.3-0.6), respectively. Protection increased with duration of OC use and persisted more than 20 years after cessation. Circulatory disease mortality was not increased, the RR for ever-use of OCs being 0.9 (CI 0.7-1.1). The overall mortality RR for all women smoking 15+ cigarettes daily was 2.25 (CI 1.99-2.53) and, for all women with a body mass index of 28+ kg/m(2), was 1.33 (CI 1.07-1.64).
Long-term follow-up strongly suggests that OC use slightly reduces all cause mortality.
本分析更新了牛津计划生育协会（Oxford-FPA）避孕研究中的死亡率，重点关注口服避孕药（OC）的使用。
牛津-FPA 研究包括 1968 年至 1974 年在避孕诊所招募的 17032 名年龄在 25-39 岁的女性，她们使用 OCs、隔膜或宫内节育器。随访至 2009 年 3 月；截至那时，已有 1715 名女性死亡。
与从未使用过 OCs 的女性相比，OC 使用者的总死亡率比为 0.87（CI 0.79-0.96）。致命宫颈癌的风险比（RR）增加（7.3），但 CI 非常宽（1.2-305）。OC 使用与乳腺癌死亡率之间没有关联（RR 1.0，CI 0.8-1.2），也与 OC 使用时间无关。OC 使用可强烈预防其他子宫癌和卵巢癌的死亡；OC 使用者的 RR 分别为 0.3（CI 0.1-0.8）和 0.4（CI 0.3-0.6）。保护作用随 OC 使用时间的延长而增加，并在停药 20 多年后仍持续存在。循环系统疾病死亡率没有增加，OC 使用者的 RR 为 0.9（CI 0.7-1.1）。每天吸烟 15 支以上的所有女性的总死亡率 RR 为 2.25（CI 1.99-2.53），所有 BMI 为 28kg/m² 以上的女性的 RR 为 1.33（CI 1.07-1.64）。
长期随访强烈表明，OC 使用略微降低了所有原因的死亡率。
