Weiss N S, Sayvetz T A
N Engl J Med. 1980 Mar 6;302(10):551-4. doi: 10.1056/NEJM198003063021004.
Female residents of King and Ierce Counties in the state of Washington in whom endometrial cancer was diagnosed during 1975--77 were interviewed concerning prior use of oral contraceptives. Their responses were compared with those of a random sample of women from the same population. Women who had taken Oracon (0.1 mg of ethinyl estradiol and 25 mg of dimethisterone) were estimated to have a risk of endometrial cancer 7.3 times that of other women (P = 0.007). This elevation in risk was not seen in users of other sequential preparations. Women who had used combined oral contraceptives had only 50 per cent of the incidence of endometrial cancer of nonusers (P = 0.05), although the protective effect was not evident among those who subsequently took menopausal estrogens for more than two years. These associations suggest that development of neoplasia in the endometrium can be extremely sensitive to hormonal factors: if an oral contraceptive, like Oracon, emphasizes the estrogenic component, promotion of cancer can result; if like combined preparations, the contraceptive emphasizes the progestational component, protection against cancer can result.
对1975年至1977年期间在华盛顿州金县和艾尔斯县被诊断患有子宫内膜癌的女性居民，就其先前使用口服避孕药的情况进行了访谈。将她们的回答与来自同一人群的随机抽样女性的回答进行了比较。服用Oracon（0.1毫克炔雌醇和25毫克甲地孕酮）的女性患子宫内膜癌的风险估计是其他女性的7.3倍（P = 0.007）。在使用其他序贯制剂的女性中未观察到这种风险升高。使用复方口服避孕药的女性子宫内膜癌发病率仅为未使用者的50%（P = 0.05），尽管在随后服用绝经后雌激素超过两年的女性中，这种保护作用并不明显。这些关联表明，子宫内膜肿瘤的发生对激素因素可能极其敏感：如果一种口服避孕药，如Oracon，强调雌激素成分，可能会导致癌症的促进；如果像复方制剂那样，避孕药强调孕激素成分，则可能会产生预防癌症的效果。
