Authors:
Vessey MP. Villard-Mackintosh L. McPherson K. Yeates D.
Institution:
Dept. of Community Medicine, Radcliffe Infirmary,Oxford OX2 6HE; United Kingdom.
Title:
Mortality among oral contraceptive users: 20 year follow up of women in a cohort study (1989-56).
Source:
BMJ. Vol 299(6714) (pp487-1491), 1989.
Abstract:
Objectives:
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 were 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 combined oral contraceptive 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.
Please click on the required question.
- 1 What is an oral contraceptive?
- 2 How popular are oral contraceptive pills?
- 3 What are the benefits of the combined oral contraceptive pill?
- 4 Will the combined oral contraceptive pill improve my periods?
- 5 Could the combined oral contraceptive pill change my libido (sex drive)
- 6 What are the risks of taking combined oral contraceptive pills?
- 7 What side effects could I have whilst taking the combined oral contraceptive pill?
- 8 What is the effect of the combined oral contraceptive pill on body weight?
- 9 Will the combined oral contraceptive pill increase my vaginal discharge?
- 10 Does the combined oral contraceptive pill increase the chance of pelvic infections?
- 11 What is the relationship between the combined oral contraceptive pill and fibroids?
- 12 Could a combined oral contraceptive pill increase my blood pressure?
- 13 Do combined oral contraceptive pills have any effect on the blood?
- 14 What is the relationship between the combined oral contraceptive pill and thromboembolism?
- 15 What is the relationship between the combined oral contraceptive pill and heart attacks?
- 16 What is the relationship between the combined oral contraceptive pill and strokes?
- 17 Does the combined oral contraceptive pill affect the breasts?
- 18 Could I feel depressed as a result of taking the combined oral contraceptive pill?
- 19 What is the relationship between the combined oral contraceptive pill and cancer of the ovary?
- 20 What is the relationship between the combined oral contraceptive pill and cancer of the uterus?
- 21 What is the relationship between the combined oral contraceptive pill and cancer of the cervix?
- 22 What is the relationship between the combined oral contraceptive pill and cancer of the breast?
- 23 Family Planning Support Groups.
- 24 Support Groups.
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