Paffenbarger R S, Fasal E, Simmons M E, Kampert J B
Cancer. 1977 Apr;39(4 Suppl):1887-91. doi: 10.1002/1097-0142(197704)39:4+<1887::aid-cncr2820390822>3.0.co;2-i.
A case-control study of 452 breast cancer patients, aged less than 50 years, and 872 age-, race-, and religion-matched control patients generated relative risk estimates of breast cancer associated with oral contraceptive practices. The relative risk of breast cancer from ever-use of oral contraceptives was 1.1, not significant. Relative risks did not differ by age, interval since first use, interval since last use, or time periods in which steroid compounds differed in composition and potency. However, the relative risks of breast cancer from current use, from 2 to 4 years of ever-use, from 6 or more years of use by women with prior benign breast disease, and from use before first childbirth were increased significantly. The findings suggest the malignant process may be quickened if transformed cells are present during oral contraceptive use. Yet, the findings neither indicate that oral contraception induces breast cancer nor do they exonerate female steroid hormones. The findings do encourage continued surveillance of steroid contraception for cancer induction or promotion. In addition to duration of oral contraceptive use and other measures of dose response, future observations should pay especial attention to use by women before first childbirth and by women with already established benign breast disease.
一项针对452名年龄小于50岁的乳腺癌患者以及872名年龄、种族和宗教相匹配的对照患者的病例对照研究得出了与口服避孕药使用相关的乳腺癌相对风险估计值。曾经使用口服避孕药患乳腺癌的相对风险为1.1,无统计学意义。相对风险在年龄、首次使用后的间隔时间、末次使用后的间隔时间或类固醇化合物成分和效力不同的时间段方面并无差异。然而,当前使用、曾经使用2至4年、既往有良性乳腺疾病的女性使用6年或更长时间以及首次分娩前使用口服避孕药患乳腺癌的相对风险显著增加。研究结果表明,如果在使用口服避孕药期间存在转化细胞,恶性过程可能会加快。然而,这些结果既未表明口服避孕药会诱发乳腺癌,也没有免除女性甾体激素的嫌疑。这些结果确实鼓励继续监测甾体避孕药对癌症诱发或促进的作用。除了口服避孕药的使用时长和其他剂量反应指标外,未来的观察应特别关注首次分娩前女性以及已患有良性乳腺疾病的女性的使用情况。