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Mortality among oral contraceptive users: 20 year follow up of women in a cohort study.
BMJ 1989; 299(6714):1487-91BMJ

Abstract

OBJECTIVE

To see whether the use of oral contraceptives influences mortality.

DESIGN

Non-randomised cohort study of 17,032 women followed up on an annual basis for an average of nearly 16 years.

SETTING

17 Family planning clinics in England and Scotland.

SUBJECTS

Women recruited during 1968-74. At the time of recruitment each woman was aged 25-39, married, a white British subject, willing to participate, and either a current user of oral contraceptives or a current user of a diaphragm or intrauterine device (without previous exposure to the pill).

MAIN OUTCOME MEASURES

Overall mortality and cause specific mortality.

RESULTS

238 Deaths occurred during the follow up period. The main analyses concerned women entering the study while using either oral contraceptives or a diaphragm or intrauterine device. The overall relative risk of death in the oral contraceptive users was 0.9 (95% confidence interval 0.7 to 1.2). Though the numbers of deaths were small in most individual disease categories, the trends observed were generally consistent with findings in other reports. Thus the relative risk of death in the oral contraceptive users was 4.9 (95% confidence interval 0.7 to 230) for cancer of the cervix, 3.3 (95% confidence interval 0.9 to 17.9) for ischaemic heart disease, and 0.4 (95% confidence interval 0.1 to 1.2) for ovarian cancer. There was a linear trend in the death rates from cervical cancer and ovarian cancer (in opposite directions) with total duration of oral contraceptive use. Death rates from breast cancer (relative risk 0.9; 95% confidence interval 0.5 to 1.4) and suicide and probable suicide (relative risk 1.1; 95% confidence interval 0.3 to 3.6) were much the same in the two contraceptive groups. In 1981 the relative risk of death in oral contraceptive users from circulatory diseases as a group was reported to be 4.2 (95% confidence interval 2.3 to 7.7) in the Royal College of General Practitioners oral contraception study. The corresponding relative risk in this study was only 1.5 (95% confidence interval 0.7 to 3.0).

CONCLUSIONS

These findings contain no significant evidence of any overall effect of oral contraceptive use on mortality. None the less, only small numbers of deaths occurred during the study period and a significant adverse (or beneficial) overall effect might emerge in the future. Interestingly, the mortality from circulatory disease associated with oral contraceptive use was substantially less than that found in the Royal College of General Practitioners study.

Authors+Show Affiliations

Department of Community Medicine and General Practice, Radcliffe, Infirmary, Oxford.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

2514858

Citation

Vessey, M P., et al. "Mortality Among Oral Contraceptive Users: 20 Year Follow Up of Women in a Cohort Study." BMJ (Clinical Research Ed.), vol. 299, no. 6714, 1989, pp. 1487-91.
Vessey MP, Villard-Mackintosh L, McPherson K, et al. Mortality among oral contraceptive users: 20 year follow up of women in a cohort study. BMJ. 1989;299(6714):1487-91.
Vessey, M. P., Villard-Mackintosh, L., McPherson, K., & Yeates, D. (1989). Mortality among oral contraceptive users: 20 year follow up of women in a cohort study. BMJ (Clinical Research Ed.), 299(6714), pp. 1487-91.
Vessey MP, et al. Mortality Among Oral Contraceptive Users: 20 Year Follow Up of Women in a Cohort Study. BMJ. 1989 Dec 16;299(6714):1487-91. PubMed PMID: 2514858.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mortality among oral contraceptive users: 20 year follow up of women in a cohort study. AU - Vessey,M P, AU - Villard-Mackintosh,L, AU - McPherson,K, AU - Yeates,D, PY - 1989/12/16/pubmed PY - 1989/12/16/medline PY - 1989/12/16/entrez KW - Barrier Methods KW - Breast Cancer KW - Cancer KW - Causes Of Death KW - Cervical Cancer KW - Cohort Analysis KW - Comparative Studies KW - Contraception KW - Contraceptive Methods KW - Death Rate KW - Demographic Factors KW - Developed Countries KW - Diseases KW - England KW - Europe KW - Family Planning KW - Ischemia KW - Iud KW - Longitudinal Studies KW - Mortality KW - Neoplasms KW - Northern Europe KW - Oral Contraceptives KW - Ovarian Cancer KW - Population KW - Population Dynamics KW - Research Methodology KW - Research Report KW - Scotland KW - Studies KW - Suicide KW - Time Factors KW - United Kingdom KW - Vaginal Barrier Methods KW - Vaginal Diaphragm KW - Vascular Diseases SP - 1487 EP - 91 JF - BMJ (Clinical research ed.) JO - BMJ VL - 299 IS - 6714 N2 - OBJECTIVE: To see whether the use of oral contraceptives influences mortality. DESIGN: Non-randomised cohort study of 17,032 women followed up on an annual basis for an average of nearly 16 years. SETTING: 17 Family planning clinics in England and Scotland. SUBJECTS: Women recruited during 1968-74. At the time of recruitment each woman was aged 25-39, married, a white British subject, willing to participate, and either a current user of oral contraceptives or a current user of a diaphragm or intrauterine device (without previous exposure to the pill). MAIN OUTCOME MEASURES: Overall mortality and cause specific mortality. RESULTS: 238 Deaths occurred during the follow up period. The main analyses concerned women entering the study while using either oral contraceptives or a diaphragm or intrauterine device. The overall relative risk of death in the oral contraceptive users was 0.9 (95% confidence interval 0.7 to 1.2). Though the numbers of deaths were small in most individual disease categories, the trends observed were generally consistent with findings in other reports. Thus the relative risk of death in the oral contraceptive users was 4.9 (95% confidence interval 0.7 to 230) for cancer of the cervix, 3.3 (95% confidence interval 0.9 to 17.9) for ischaemic heart disease, and 0.4 (95% confidence interval 0.1 to 1.2) for ovarian cancer. There was a linear trend in the death rates from cervical cancer and ovarian cancer (in opposite directions) with total duration of oral contraceptive use. Death rates from breast cancer (relative risk 0.9; 95% confidence interval 0.5 to 1.4) and suicide and probable suicide (relative risk 1.1; 95% confidence interval 0.3 to 3.6) were much the same in the two contraceptive groups. In 1981 the relative risk of death in oral contraceptive users from circulatory diseases as a group was reported to be 4.2 (95% confidence interval 2.3 to 7.7) in the Royal College of General Practitioners oral contraception study. The corresponding relative risk in this study was only 1.5 (95% confidence interval 0.7 to 3.0). CONCLUSIONS: These findings contain no significant evidence of any overall effect of oral contraceptive use on mortality. None the less, only small numbers of deaths occurred during the study period and a significant adverse (or beneficial) overall effect might emerge in the future. Interestingly, the mortality from circulatory disease associated with oral contraceptive use was substantially less than that found in the Royal College of General Practitioners study. SN - 0959-8138 UR - https://www.unboundmedicine.com/medline/citation/2514858/Mortality_among_oral_contraceptive_users:_20_year_follow_up_of_women_in_a_cohort_study_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/2514858/ DB - PRIME DP - Unbound Medicine ER -