Rosenberg L, Palmer J R, Zauber A G, Warshauer M E, Lewis J L, Strom B L, Harlap S, Shapiro S
Slone Epidemiology Unit, School of Public Health, Boston University School of Medicine, Brookline, MA 02146.
Am J Epidemiol. 1994 Apr 1;139(7):654-61. doi: 10.1093/oxfordjournals.aje.a117055.
The relation of oral contraceptive use to the risk of ovarian cancer was assessed with data collected during 1977-1991 from patients under 65 years of age in hospitals in Boston, New York, Philadelphia, and Baltimore. We compared 441 women with recently diagnosed invasive epithelial ovarian cancer to 2,065 control women. Logistic regression was used to control risk factors for ovarian cancer. The multivariate relative risk estimate decreased with the increasing duration of oral contraceptive use (p < 0.05): the estimate was close to 1.0 for duration categories of less than 3 years; it was reduced for the categories of 3-4 years of use and greater, but it did not decline further as the duration of use increased. For > or = 3 years of use, the estimate was 0.6 (95% confidence interval 0.4-0.8). The inverse association of risk with > or = 3 years of use was consistently present across categories of age, parity, interview year, and geographic area. It was apparent for as long as 15-19 years after cessation. Many different specific oral contraceptive formulations appeared related to a decreased risk; however, data were sparse for the newer types, particularly phasic preparations, and the ability to assess specific preparations in the context of use of multiple preparations was limited. The present data confirm previous reports of an inverse association of ovarian cancer risk with oral contraceptive use of several years in duration. They also suggest that the association may persist for as long as two decades and that it is not confined to any particular type of oral contraceptive formulation.
利用1977年至1991年期间从波士顿、纽约、费城和巴尔的摩医院收集的65岁以下患者的数据，评估了口服避孕药的使用与卵巢癌风险之间的关系。我们将441名近期诊断为浸润性上皮性卵巢癌的女性与2065名对照女性进行了比较。采用逻辑回归来控制卵巢癌的风险因素。多变量相对风险估计值随着口服避孕药使用时间的增加而降低（p<0.05）：使用时间少于3年的类别估计值接近1.0；使用3至4年及更长时间的类别估计值降低，但随着使用时间的增加并未进一步下降。对于使用时间≥3年的情况，估计值为0.6（95%置信区间0.4 - 0.8）。在年龄、生育次数、访谈年份和地理区域的各个类别中，使用时间≥3年与风险的负相关关系始终存在。在停止使用后长达15至19年都很明显。许多不同的特定口服避孕药配方似乎都与风险降低有关；然而，关于新型避孕药的数据很少，尤其是复方制剂，并且在使用多种制剂的情况下评估特定制剂的能力有限。目前的数据证实了先前关于卵巢癌风险与持续数年口服避孕药使用呈负相关的报道。它们还表明这种关联可能持续长达二十年，并且不限于任何特定类型的口服避孕药配方。
