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
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ContraceptionAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Mortality in relation to oral contraceptive use and cigarette smoking.Lancet. 2003; 362: 185-191
- A long-term follow-up study of women using different methods of contraception.J Biosoc Sci. 1976; 8: 373-427
- Statistical methods in cancer research: the design and analysis of cohort studies, II. International Agency for Research on Cancer, Lyon1987: 81-118
- 30th Anniversary of the Oxford-FPA contraceptive study.Trends Urol Gynaecol Sexual Health. 1998; 3: 26-33
- Safety concerns and health benefits associated with oral contraception.Am J Obstet Gynecol. 2004; 190: S5-S22
- Effect of tobacco smoking on survival of men and women by social position: a 28-year cohort study.Br Med J. 2009; b480: 338
- Women and smoking: a report of the Surgeon General-2001.US Department of Health and Human Services, Washington, DC2001
- Body mass index and cause-specific mortality in 900,000 adults: collaborative analyses of 57 prospective studies.Lancet. 2009; 373: 1083-1096
- Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53,297 women with breast cancer and 100,239 women without breast cancer from 54 epidemiological studies.Lancet. 1996; 347: 1713-1727
- Noncontraceptive health benefits of combined oral contraception.Hum Rep Update. 2005; 11: 513-525
- Cervical cancer and use of hormonal contraceptives: a systematic review.Lancet. 2003; 361: 1159-1167
- Mortality among contraceptive pill users: cohort evidence from the Royal College of General Practitioners Oral Contraception Study.Brit Med J. 2010; c927: 340
- Oral contraceptive use and mortality during 12 years of follow-up: The Nurses' Health Study Group.Ann Intern Med. 1994; 120: 821-826
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.
