Jewett Patricia I, Gangnon Ronald E, Trentham-Dietz Amy, Sprague Brian L
Departments of Population Health Sciences and Biostatistics and Medical Informatics, University of Wisconsin, and the University of Wisconsin Carbone Cancer Center, Madison, Wisconsin; and the Department of Surgery and Vermont Cancer Center, University of Vermont, Burlington, Vermont.
Obstet Gynecol. 2014 Oct;124(4):727-733. doi: 10.1097/AOG.0000000000000469.
To estimate long term trends in estrogen-progestin prevalence for the U.S. female population by year and age.
We integrated data on oral estrogen-progestin use from the National Health and Nutrition Examination Survey 1999-2010 with data from the National Prescription Audit 1970-2003. Distributions of estrogen-progestin by age from the National Health and Nutrition Examination Survey were applied to the prescription data, and calibration and interpolation procedures were used to generate estrogen-progestin prevalence estimates by single year of age and single calendar year for 1970-2010.
Estimated prevalence of oral estrogen-progestin was below 0.5% in the 1970s, began to rise in the early 1980s, and almost tripled between 1990 and the late 1990s. The age-adjusted prevalence for women aged 45-64 years peaked at 13.5% in 1999 with highest use among 57-year-old women (23.2%). Prevalence of estrogen-progestin use declined dramatically in the early 2000s with only 2.7% of women aged 45-64 years using estrogen-progestin in 2010, which is comparable to prevalence levels in the mid-1980s.
The dramatic rise and fall of estrogen-progestin use over the past 40 years provides an illuminating case study of prescription practices before, during, and after the development of evidence regarding benefits and harms.
: II.
按年份和年龄估算美国女性人群中雌激素 - 孕激素的长期使用趋势。
我们将1999 - 2010年国家健康与营养检查调查中口服雌激素 - 孕激素使用的数据与1970 - 2003年国家处方审计的数据相结合。将国家健康与营养检查调查中按年龄划分的雌激素 - 孕激素分布应用于处方数据，并使用校准和插值程序生成1970 - 2010年按单一年龄和单一日历年的雌激素 - 孕激素患病率估计值。
20世纪70年代口服雌激素 - 孕激素的估计患病率低于0.5%，在80年代初开始上升，在1990年至90年代末之间几乎增长了两倍。45 - 64岁女性的年龄调整患病率在1999年达到峰值13.5%，其中57岁女性的使用率最高（23.2%）。21世纪初雌激素 - 孕激素的使用率急剧下降，2010年45 - 64岁女性中只有2.7%使用雌激素 - 孕激素，这与80年代中期的患病率水平相当。
过去40年中雌激素 - 孕激素使用的急剧上升和下降为在有关益处和危害的证据出现之前、期间和之后的处方实践提供了一个有启发性的案例研究。
II级。
