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Mortality associated with oral contraceptive use: 25 year follow up of cohort of 46 000 women from Royal College of General Practitioners' oral contraception study.
BMJ. 1999 Jan 09; 318(7176):96-100.BMJ

Abstract

OBJECTIVE

To describe the long term effects of the use of oral contraceptives on mortality.

DESIGN

Cohort study with 25 year follow up. Details of oral contraceptive use and of morbidity and mortality were reported six monthly by general practitioners. 75% of the original cohort was "flagged" on the NHS central registers.

SETTING

1400 general practices throughout Britain.

SUBJECTS

46 000 women, half of whom were using oral contraceptives at recruitment in 1968-9. Median age at end of follow up was 49 years.

MAIN OUTCOME MEASURES

Relative risks of death adjusted for age, parity, social class, and smoking.

RESULTS

Over the 25 year follow up 1599 deaths were reported. Over the entire period of follow up the risk of death from all causes was similar in ever users and never users of oral contraceptives (relative risk=1.0, 95% confidence interval 0.9 to 1.1; P=0.7) and the risk of death for most specific causes did not differ significantly in the two groups. However, among current and recent (within 10 years) users the relative risk of death from ovarian cancer was 0.2 (0.1 to 0.8; P=0.01), from cervical cancer 2.5 (1.1 to 6.1; P=0.04), and from cerebrovascular disease 1.9 (1.2 to 3.1, P=0.009). By contrast, for women who had stopped use >/= 10 years previously there were no significant excesses or deficits either overall or for any specific cause of death.

CONCLUSION

Oral contraceptives seem to have their main effect on mortality while they are being used and in the 10 years after use ceases. Ten or more years after use ceases mortality in past users is similar to that in never users.

Authors+Show Affiliations

Imperial Cancer Research Fund, Cancer Epidemiology Unit, Radcliffe Infirmary, Oxford OX2 6HE. beral@icrf.icnet.ukNo affiliation info availableNo affiliation info availableNo 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

9880284

Citation

Beral, V, et al. "Mortality Associated With Oral Contraceptive Use: 25 Year Follow Up of Cohort of 46 000 Women From Royal College of General Practitioners' Oral Contraception Study." BMJ (Clinical Research Ed.), vol. 318, no. 7176, 1999, pp. 96-100.
Beral V, Hermon C, Kay C, et al. Mortality associated with oral contraceptive use: 25 year follow up of cohort of 46 000 women from Royal College of General Practitioners' oral contraception study. BMJ. 1999;318(7176):96-100.
Beral, V., Hermon, C., Kay, C., Hannaford, P., Darby, S., & Reeves, G. (1999). Mortality associated with oral contraceptive use: 25 year follow up of cohort of 46 000 women from Royal College of General Practitioners' oral contraception study. BMJ (Clinical Research Ed.), 318(7176), 96-100.
Beral V, et al. Mortality Associated With Oral Contraceptive Use: 25 Year Follow Up of Cohort of 46 000 Women From Royal College of General Practitioners' Oral Contraception Study. BMJ. 1999 Jan 9;318(7176):96-100. PubMed PMID: 9880284.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mortality associated with oral contraceptive use: 25 year follow up of cohort of 46 000 women from Royal College of General Practitioners' oral contraception study. AU - Beral,V, AU - Hermon,C, AU - Kay,C, AU - Hannaford,P, AU - Darby,S, AU - Reeves,G, PY - 1999/1/8/pubmed PY - 1999/1/8/medline PY - 1999/1/8/entrez KW - Biology KW - Cancer KW - Causes Of Death KW - Cerebrovascular Effects KW - Cervical Cancer KW - Contraception KW - Contraceptive Methods KW - Contraceptive Usage KW - Demographic Factors KW - Developed Countries KW - Diseases KW - Europe KW - Excess Mortality KW - Family Planning KW - Mortality KW - Neoplasms KW - Northern Europe KW - Oral Contraceptives KW - Physiology KW - Population KW - Population Dynamics KW - Research Report KW - Risk Factors KW - United Kingdom SP - 96 EP - 100 JF - BMJ (Clinical research ed.) JO - BMJ VL - 318 IS - 7176 N2 - OBJECTIVE: To describe the long term effects of the use of oral contraceptives on mortality. DESIGN: Cohort study with 25 year follow up. Details of oral contraceptive use and of morbidity and mortality were reported six monthly by general practitioners. 75% of the original cohort was "flagged" on the NHS central registers. SETTING: 1400 general practices throughout Britain. SUBJECTS: 46 000 women, half of whom were using oral contraceptives at recruitment in 1968-9. Median age at end of follow up was 49 years. MAIN OUTCOME MEASURES: Relative risks of death adjusted for age, parity, social class, and smoking. RESULTS: Over the 25 year follow up 1599 deaths were reported. Over the entire period of follow up the risk of death from all causes was similar in ever users and never users of oral contraceptives (relative risk=1.0, 95% confidence interval 0.9 to 1.1; P=0.7) and the risk of death for most specific causes did not differ significantly in the two groups. However, among current and recent (within 10 years) users the relative risk of death from ovarian cancer was 0.2 (0.1 to 0.8; P=0.01), from cervical cancer 2.5 (1.1 to 6.1; P=0.04), and from cerebrovascular disease 1.9 (1.2 to 3.1, P=0.009). By contrast, for women who had stopped use >/= 10 years previously there were no significant excesses or deficits either overall or for any specific cause of death. CONCLUSION: Oral contraceptives seem to have their main effect on mortality while they are being used and in the 10 years after use ceases. Ten or more years after use ceases mortality in past users is similar to that in never users. SN - 0959-8138 UR - https://www.unboundmedicine.com/medline/citation/9880284/Mortality_associated_with_oral_contraceptive_use:_25_year_follow_up_of_cohort_of_46_000_women_from_Royal_College_of_General_Practitioners'_oral_contraception_study_ L2 - http://www.bmj.com/cgi/pmidlookup?view=long&pmid=9880284 DB - PRIME DP - Unbound Medicine ER -