Chilvers C E
University of Nottingham Medical School, Nottingham, UK.
Drug Saf. 1996 Sep;15(3):212-8. doi: 10.2165/00002018-199615030-00006.
Depot medroxyprogesterone acetate (DMPA) has been used worldwide since 1964 as a contraceptive and by 1993 was in use in more than 90 countries. It was licensed for contraceptive use in the US in 1992. One of the reasons for this delay in licensing in the US was the possibility of an increased risk of breast cancer associated with its use. A pooled analysis has recently been published, which brings together the data from 2 large studies of breast cancer risk associated with DMPA use. The overall results are reassuring, but there is some evidence of an increased risk of breast cancer associated with recent use of DMPA. There are substantial difficulties in interpreting this increase in risk. It is certainly possible that it may be the result of surveillance bias, although it could be a short term increase in risk that is not in fact sustained. The conclusion that DMPA should not be restricted as a contraceptive, provided that appropriate advice is given before use, is well-founded. However, further epidemiological work is needed on the long term effects of DMPA.
醋酸甲羟孕酮长效注射剂（DMPA）自1964年起在全球范围内用作避孕药，到1993年已在90多个国家使用。1992年它在美国获得避孕药使用许可。美国在许可方面出现延迟的原因之一是其使用可能会增加患乳腺癌的风险。最近发表了一项汇总分析，该分析汇集了两项关于使用DMPA与乳腺癌风险的大型研究的数据。总体结果令人放心，但有一些证据表明近期使用DMPA会增加患乳腺癌的风险。解读这种风险增加存在很大困难。这很可能是监测偏倚的结果，尽管也可能是实际上不会持续的短期风险增加。只要在使用前给出适当建议，DMPA不应作为避孕药受到限制这一结论是有充分依据的。然而，需要进一步开展关于DMPA长期影响的流行病学研究。
