JAMA. 1983 Mar 25;249(12):1591-5.
Using oral contraceptives for long periods or using them when one has other risk factors has been hypothesized to increase the risk of breast cancer. To study these issues, we analyzed data from a multicenter, case-control investigation--the Centers for Disease Control's Cancer and Steroid Hormone Study. All women 20 to 54 years old with a first diagnosis of breast cancer ascertained by eight population-based cancer registries are study subjects; controls are selected at random from the general population of these eight areas. Analysis of the first 689 cases and 1,077 controls studied showed that women who had used oral contraceptives at some time in their lives had a relative risk of 0.9 compared with never-users (95% confidence interval, 0.8 to 1.2). Neither duration of oral contraceptive use nor time since first use altered a user's risk of breast cancer; women whose first use was more than 15 years ago and who used oral contraceptives for 11 years or more had a relative risk of 0.8 (0.5 to 1.4). Oral contraceptive use did not increase the risk of breast cancer among women with benign breast disease or a family history of breast cancer. Oral contraceptive use before a woman's first pregnancy did not increase her risk of breast cancer significantly more than other methods of delaying first pregnancy. This study provides no support to the hypothesis that oral contraceptive use increases a woman's risk of breast cancer.
长期使用口服避孕药或在存在其他风险因素时使用口服避孕药被认为会增加患乳腺癌的风险。为研究这些问题,我们分析了来自一项多中心病例对照调查的数据——疾病控制中心的癌症与类固醇激素研究。所有年龄在20至54岁之间、首次诊断为乳腺癌且由八个基于人群的癌症登记处确诊的女性均为研究对象;对照组从这八个地区的普通人群中随机选取。对首批研究的689例病例和1077名对照的分析表明,一生中曾在某些时候使用过口服避孕药的女性与从未使用者相比,相对风险为0.9(95%置信区间,0.8至1.2)。口服避孕药的使用时长和首次使用后的时间均未改变使用者患乳腺癌的风险;首次使用时间超过15年且使用口服避孕药11年或更长时间的女性相对风险为0.8(0.5至1.4)。在患有良性乳腺疾病或有乳腺癌家族史的女性中,使用口服避孕药并未增加患乳腺癌的风险。在女性首次怀孕前使用口服避孕药,相比其他推迟首次怀孕的方法,并未显著增加其患乳腺癌的风险。本研究不支持使用口服避孕药会增加女性患乳腺癌风险这一假设。