Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/19780
Title: Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23 257 women with ovarian cancer and 87 303 controls
Authors: V. Beral
R. Doll
C. Hermon
R. Peto
G. Reeves
L. Brinton
A. C. Green
P. Marchbanks
E. Negri
R. Ness
P. Peeters
M. Vessey
E. E. Calle
C. Rodriguez
L. Dal Maso
R. Talamini
D. Cramer
S. E. Hankinson
S. S. Tworoger
A. Chetrit
G. Hirsh-Yechezkel
F. Lubin
S. Sadetzki
P. Appleby
E. Banks
A. Berrington de Gonzalez
D. Bull
B. Crossley
A. Goodill
I. Green
J. Green
T. Key
R. Collins
C. A. Gonzalez
N. Lee
H. W. Ory
H. B. Peterson
P. A. Wingo
N. Martin
T. Pardthaisong
S. Silpisornkosol
C. Theetranont
B. Boosiri
S. Chutivongse
P. Jimakorn
P. Virutamasen
C. Wongsrichanalai
L. Titus-Ernstoff
B. J. Mosgaard
D. Yeates
J. Chang-Claude
M. A. Rossing
D. Thomas
N. Weiss
S. Franceschi
C. La Vecchia
H. O. Adami
C. Magnusson
T. Riman
E. Weiderpass
A. Wolk
L. A. Brinton
D. M. Freedman
P. Hartge
J. M. Lacey
R. Hoover
L. J. Schouten
P. A. van den Brandt
N. Chantarakul
S. Koetsawang
D. Rachawat
S. Graff-Iversen
R. Selmer
C. J. Bain
D. M. Purdie
V. Siskind
P. M. Webb
S. E. McCann
P. Hannaford
C. Kay
C. W. Binns
A. H. Lee
M. Zhang
P. Nasca
P. F. Coogan
L. Rosenberg
J. Kelsey
R. Paffenbarger
A. Whittemore
K. Katsouyanni
A. Trichopoulou
D. Trichopoulos
A. Tzonou
A. Dabancens
L. Martinez
R. Molina
O. Salas
M. T. Goodman
G. Laurie
American Cancer Society
IRCCS Centro Di Riferimento Oncologico Aviano
Brigham and Women's Hospital
Channing Laboratory
The Gertner Institute
Cancer Epidemiology Unit
Clinical Trial Service Unit
Institute Catala Oncologia
Centers for Disease Control and Prevention
Chiang Mai University
Chulalongkorn University
Geisel School of Medicine at Dartmouth
Amtssygehuset i Herlev
Department of Public Health
German Cancer Research Center
University of Washington, Seattle
International Agency for Research on Cancer
Universita degli Studi di Milano
Karolinska Institutet
National Cancer Institute
Maastricht University
Mahidol University
Norwegian Institute of Public Health
University of Queensland
Roswell Park Cancer Institute
Royal College of General Practitioners Oral Contraception Study
Curtin University
University of Massachusetts System
Boston University
Stanford University
University of Athens Medical School
Universidad de Chile
University of Hawaii System
Skånes universitetssjukhus
University of Pittsburgh
University of Pennsylvania
University Medical Center Utrecht
University of Southern California
Universitetet i Tromso
Vanderbilt University
Organisation Mondiale de la Sante
Yale University
Keywords: Medicine
Issue Date: 26-Jan-2008
Citation: The Lancet. Vol.371, No.9609 (2008), 303-314
Abstract: Background: Oral contraceptives were introduced almost 50 years ago, and over 100 million women currently use them. Oral contraceptives can reduce the risk of ovarian cancer, but the eventual public-health effects of this reduction will depend on how long the protection lasts after use ceases. We aimed to assess these effects. Methods: Individual data for 23 257 women with ovarian cancer (cases) and 87 303 without ovarian cancer (controls) from 45 epidemiological studies in 21 countries were checked and analysed centrally. The relative risk of ovarian cancer in relation to oral contraceptive use was estimated, stratifying by study, age, parity, and hysterectomy. Findings: Overall 7308 (31%) cases and 32 717 (37%) controls had ever used oral contraceptives, for average durations among users of 4·4 and 5·0 years, respectively. The median year of cancer diagnosis was 1993, when cases were aged an average of 56 years. The longer that women had used oral contraceptives, the greater the reduction in ovarian cancer risk (p<0·0001). This reduction in risk persisted for more than 30 years after oral contraceptive use had ceased but became somewhat attenuated over time-the proportional risk reductions per 5 years of use were 29% (95% CI 23-34%) for use that had ceased less than 10 years previously, 19% (14-24%) for use that had ceased 10-19 years previously, and 15% (9-21%) for use that had ceased 20-29 years previously. Use during the 1960s, 1970s, and 1980s was associated with similar proportional risk reductions, although typical oestrogen doses in the 1960s were more than double those in the 1980s. The incidence of mucinous tumours (12% of the total) seemed little affected by oral contraceptives, but otherwise the proportional risk reduction did not vary much between different histological types. In high-income countries, 10 years use of oral contraceptives was estimated to reduce ovarian cancer incidence before age 75 from 1·2 to 0·8 per 100 users and mortality from 0·7 to 0·5 per 100; for every 5000 woman-years of use, about two ovarian cancers and one death from the disease before age 75 are prevented. Interpretation: Use of oral contraceptives confers long-term protection against ovarian cancer. These findings suggest that oral contraceptives have already prevented some 200 000 ovarian cancers and 100 000 deaths from the disease, and that over the next few decades the number of cancers prevented will rise to at least 30 000 per year. © 2008 Elsevier Ltd. All rights reserved.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=39749180158&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/19780
ISSN: 01406736
Appears in Collections:Scopus 2006-2010

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