Kjaer S K, Engholm G, Dahl C, Bock J E, Lynge E, Jensen O M
Danish Cancer Society, Copenhagen.
Cancer Causes Control. 1993 Nov;4(6):513-9. doi: 10.1007/BF00052426.
The role of oral contraceptive (OC) use in relation to the risk of cervical neoplasia (squamous cell) was investigated in a population-based case-control study in Denmark of 586 women with histologically verified cervical carcinoma in situ (CIS), 59 women with invasive cervical cancer from Copenhagen, and 614 controls drawn at random from the female population in the study area. Ever use of OCs was associated with an increased crude risk for carcinoma in situ (relative risk [RR] = 1.8, 95 percent confidence interval [CI] = 1.3-2.5). The crude risk in relation to invasive carcinoma was 1.6 (CI = 0.7-3.5). After adjustment for potential confounders (excluding human papillomavirus), the risks were marginally increased, but not statistically significant (CIS: RR = 1.4, CI = 0.9-21: invasive: RR = 1.3, CI = 0.5-3.3). The risk increased with duration of use; compared with never users, the adjusted RR for carcinoma in situ was 1.9 (CI = 1.1-3.1) for women who had used OCs for six to nine years, and 1.7 (CI = 1.0-2.7) for women who used OCs for 10 years or more. This was independent of years since last use since both recent and non-recent long-term users were at an increased risk. This trend in risk with duration did not apply to the same extent to invasive lesions. The observation that the risks related to OC use were found both in women who had ever had a Pap smear and in women who had never been screened previously may speak against detection bias as an important factor.
在丹麦进行的一项基于人群的病例对照研究中，调查了口服避孕药（OC）的使用与宫颈肿瘤（鳞状细胞）风险之间的关系。该研究纳入了586名经组织学证实为宫颈原位癌（CIS）的女性、59名来自哥本哈根的浸润性宫颈癌女性以及从研究区域的女性人群中随机抽取的614名对照。曾经使用OC与原位癌的粗风险增加相关（相对风险[RR]=1.8，95%置信区间[CI]=1.3 - 2.5）。与浸润性癌相关的粗风险为1.6（CI = 0.7 - 3.5）。在对潜在混杂因素（不包括人乳头瘤病毒）进行调整后，风险略有增加，但无统计学意义（CIS：RR = 1.4，CI = 0.9 - 2.1；浸润性：RR = 1.3，CI = 0.5 - 3.3）。风险随着使用时间的延长而增加；与从未使用者相比，使用OC六年至九年的女性原位癌调整后RR为1.9（CI = 1.1 - 3.1），使用OC十年或更长时间的女性为1.7（CI = 1.0 - 2.7）。这与自上次使用以来的年限无关，因为近期和非近期的长期使用者风险均增加。这种风险随使用时间的趋势在浸润性病变中并不完全适用。在曾经进行过巴氏涂片检查的女性和从未接受过筛查的女性中均发现与OC使用相关的风险，这一观察结果可能表明检测偏倚并非重要因素。
