Schlesselman J J
Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814.
Am J Obstet Gynecol. 1990 Oct;163(4 Pt 2):1379-87. doi: 10.1016/0002-9378(90)91352-d.
Among women in general the risk of breast cancer through 59 years of age does not appear to be affected appreciably by the use of oral contraceptives. Nonetheless, concern continues to be expressed about the effects of early age at first use, long-term duration of use, formulation, and a variety of other factors thought to influence breast cancer risk in the presence of oral contraception. A number of recent studies restricted to young women suggest that long-term use may increase the risk of disease occurring very early, but the present lack of consistent findings in well-conducted epidemiologic studies prevents any certain conclusion with regard to cause-and-effect. However, if an increased risk were indeed present, the most plausible interpretation is that long-term oral contraception promotes earlier clinical manifestation of breast cancer in some women while having no net impact on their lifetime risk of the disease.
总体而言,59岁及以下女性使用口服避孕药似乎不会明显影响患乳腺癌的风险。尽管如此,人们仍持续关注首次使用年龄早、使用时间长、剂型以及其他各种被认为在使用口服避孕药情况下会影响乳腺癌风险的因素。最近一些针对年轻女性的研究表明,长期使用可能会增加疾病在非常早期发生的风险,但目前在开展良好的流行病学研究中缺乏一致的结果,无法就因果关系得出任何确定的结论。然而,如果确实存在风险增加的情况,最合理的解释是,长期口服避孕药会促使一些女性乳腺癌的临床表现提前出现,而对她们患该病的终生风险没有净影响。