Abstract
Background
This analysis updates mortality in the Oxford-Family Planning Association (Oxford-FPA)
contraceptive study, with emphasis on oral contraceptive (OC) use.
Study design
The Oxford-FPA study includes 17,032 women recruited from 1968���1974 at contraceptive
clinics, aged 25���39 years, using OCs a diaphragm or an intrauterine device. Follow-up
has been to March 2009; by then, 1715 women had died.
Results
The rate ratio (RR) for overall mortality was 0.87 (CI 0.79���0.96), comparing ever-users
of OCs with never-users. The RR for fatal cervical cancer was increased (7.3), but
the CIs were very wide (1.2���305). There was no association between ever-use of OCs
and mortality from breast cancer (RR 1.0, CI 0.8���1.2), nor was fatal breast cancer
related to duration of OC use. OC use strongly protected against death from other
uterine cancer and ovarian cancer; RRs for ever-use of OCs were 0.3 (CI 0.1���0.8)
and 0.4 (CI 0.3���0.6), respectively. Protection increased with duration of OC use
and persisted more than 20 years after cessation. Circulatory disease mortality was
not increased, the RR for ever-use of OCs being 0.9 (CI 0.7���1.1). The overall mortality
RR for all women smoking 15+ cigarettes daily was 2.25 (CI 1.99���2.53) and, for all
women with a body mass index of 28+ kg/m2, was 1.33 (CI 1.07���1.64).
Conclusions
Long-term follow-up strongly suggests that OC use slightly reduces all cause mortality.
Keywords
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Article info
Publication history
Published online: May 19, 2010
Accepted:
April 9,
2010
Received:
March 21,
2010
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
