Publication:
Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23 257 women with ovarian cancer and 87 303 controls

Issued Date

2008-01-26

Resource Type

Article

ISSN

01406736

DOI

10.1016/S0140-6736(08)60167-1

Other identifier(s)

2-s2.0-39749180158

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

The Lancet. Vol.371, No.9609 (2008), 303-314

Suggested Citation

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 Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23 257 women with ovarian cancer and 87 303 controls. The Lancet. Vol.371, No.9609 (2008), 303-314. doi:10.1016/S0140-6736(08)60167-1 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/19780

Research Projects

Organizational Units

Authors

Journal Issue

Thesis

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

Author(s)

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

Other Contributor(s)

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

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.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/19780

Collections

Scopus 2006-2010