Schlesselman J J
Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814.
Contraception. 1989 Jul;40(1):1-38. doi: 10.1016/0010-7824(89)90025-5.
Effects of oral contraception on cancers of the female breast and reproductive tract are critically reviewed from human studies reported since 1980. The cumulative risk of breast cancer through 59 years of age appears to bear no relationship to oral contraceptive (OC) use whatsoever. Studies restricted to women under age 45, however, raise concern about a possible adverse effect from OC use before a first-term pregnancy. A duration-related protective effect against endometrial cancer occurs from use of combined OCs. The risk is reduced by about 40% with 2 years of use, and by about 60% with 4 or more years of oral contraception. Oral contraception in excess of 3 years protects against ovarian cancer. Four years of use confers a 50% reduction in risk and 7 or more years of use confers a 60%-80% reduction in ovarian cancer risk. Studies of cervical dysplasia and carcinoma in situ suggest elevated risks with 2 or more years of OC use, although results are difficult to interpret in view of numerous factors that might distort the findings. The risk of invasive cervical cancer appear to be unaffected by up to 5 years of oral contraception. Beyond this, there is evidence suggesting an elevated risk which approaches a 2-fold increase at 10 years of use. Cancers of the vagina and fallopian tube are extremely rare. Their risks have yet to be characterized in relation to oral contraception.
自1980年以来报道的人体研究对口服避孕药对女性乳腺癌和生殖道癌症的影响进行了批判性综述。到59岁时乳腺癌的累积风险似乎与口服避孕药（OC）的使用毫无关系。然而，针对45岁以下女性的研究引发了人们对首次怀孕前使用OC可能产生的不良影响的担忧。使用复方OC可产生与使用时长相关的对子宫内膜癌的保护作用。使用2年风险降低约40%，口服避孕药使用4年或更长时间风险降低约60%。口服避孕药超过3年可预防卵巢癌。使用4年风险降低50%，使用7年或更长时间卵巢癌风险降低60%-80%。对宫颈发育异常和原位癌的研究表明，使用OC 2年或更长时间风险升高，不过鉴于可能扭曲研究结果的众多因素，结果难以解释。口服避孕药使用长达5年似乎不会影响浸润性宫颈癌的风险。除此之外，有证据表明风险升高，使用10年时风险接近翻倍。阴道癌和输卵管癌极为罕见。它们与口服避孕药相关的风险尚未明确。
