Palmer J R, Rosenberg L, Kaufman D W, Warshauer M E, Stolley P, Shapiro S
Slone Epidemiology Unit, School of Public Health, Boston University School of Medicine, Brookline, MA 02146.
Am J Epidemiol. 1989 Nov;130(5):878-82. doi: 10.1093/oxfordjournals.aje.a115420.
The risk of liver cancer in relation to use of oral contraceptives was evaluated in a hospital-based case-control study conducted in five US cities from 1977 to 1985. Twelve new cases of liver cancer were identified in women aged 19-54 years; five controls selected from among patients hospitalized for acute conditions unrelated to oral contraceptive use were matched to each case on age (five-year categories), date of interview (three-year categories), and geographic location of the hospital. Among nine cases classified as having hepatocellular carcinoma, eight (89%) had used oral contraceptives; only 16 (36%) of 45 matched controls had used oral contraceptives. Among three other cases (two with cholangiocarcinomas and one with liver cancer of undetermined type), all had used oral contraceptives, compared with four of 15 matched controls. The results confirm the strong positive association between oral contraceptive use and hepatocellular carcinoma observed in earlier studies. Such an association is consistent with evidence that oral contraceptive use is associated with benign hepatic tumors in young women. However, the number of cases of liver cancer in the United States that are attributable to oral contraceptive use is probably small, because liver cancer is extremely rare in the United States.
1977年至1985年期间，在美国五个城市开展了一项基于医院的病例对照研究，评估了口服避孕药与肝癌风险之间的关系。研究共确定了12例年龄在19至54岁之间的女性肝癌新发病例；从因与口服避孕药使用无关的急性疾病住院的患者中选取5名对照，与每例病例在年龄（按五岁分组）、访谈日期（按三年分组）和医院地理位置方面进行匹配。在分类为肝细胞癌的9例病例中，有8例（89%）使用过口服避孕药；45名匹配对照中只有16例（36%）使用过口服避孕药。在其他3例病例（2例胆管癌和1例类型未确定的肝癌）中，所有病例都使用过口服避孕药，而15名匹配对照中有4例使用过。研究结果证实了早期研究中观察到的口服避孕药使用与肝细胞癌之间的强正相关。这种关联与口服避孕药使用与年轻女性良性肝肿瘤有关的证据一致。然而，在美国，归因于口服避孕药使用的肝癌病例数可能很少，因为肝癌在美国极为罕见。
