Association between contemporary hormonal contraception and ovarian cancer in women of reproductive age in Denmark: prospective, nationwide cohort study.

Abstract:

OBJECTIVES:To investigate the association between contemporary combined hormonal contraceptives (including progestogen types in combined preparations and all progestogen-only products) and overall and specific types of ovarian cancer. DESIGN:Prospective, nationwide cohort study. SETTING:Denmark, 1995-2014. PARTICIPANTS:All women aged 15-49 years during 1995-2014 were eligible. Women were excluded if they immigrated after 1995, had cancer (except non-melanoma skin cancer), had venous thrombosis, or were treated for infertility before entry (final study population included 1 879 227 women). Women were categorised as never users (no record of being dispensed hormonal contraception), current or recent users (≤1 year after stopping use), or former users (>1 year after stopping use) of different hormonal contraceptives. MAIN OUTCOME MEASURES:Poisson regression was used to calculate relative risk of ovarian cancer among users of any contemporary combined hormonal contraceptives and by progestogen type in combined preparations and all progestogen-only products, including non-oral preparations. Separate analyses examined women followed up to their first contraception type switch and those with full contraceptive histories. Duration, time since last use, and tumour histology were examined and the population prevented fraction were calculated. RESULTS:During 21.4 million person years, 1249 incident ovarian cancers occurred. Among ever users of hormonal contraception, 478 ovarian cancers were recorded over 13 344 531 person years. Never users had 771 ovarian cancers during 8 150 250 person years. Compared with never users, reduced risks of ovarian cancer occurred with current or recent use and former use of any hormonal contraception (relative risk 0.58 (95% confidence interval 0.49 to 0.68) and 0.77 (0.66 to 0.91), respectively). Relative risks among current or recent users decreased with increasing duration (from 0.82 (0.59 to 1.12) with ≤1 year use to 0.26 (0.16 to 0.43) with >10 years' use; P<0.001 for trend). Similar results were achieved among women followed up to their first switch in contraceptive type. Little evidence of major differences in risk estimates by tumour type or progestogen content of combined oral contraceptives was seen. Use of progestogen-only products were not associated with ovarian cancer risk. Among ever users of hormonal contraception, the reduction in the age standardised absolute rate of ovarian cancer was 3.2 per 100 000 person years. Based on the relative risk for the never use versus ever use categories of hormonal contraception (0.66), the population prevented fraction was estimated to be 21%-that is, use of hormonal contraception prevented 21% of ovarian cancers in the study population. CONCLUSIONS:Use of contemporary combined hormonal contraceptives is associated with a reduction in ovarian cancer risk in women of reproductive age-an effect related to duration of use, which diminishes after stopping use. These data suggest no protective effect from progestogen-only products.

journal_name

BMJ

authors

Iversen L,Fielding S,Lidegaard Ø,Mørch LS,Skovlund CW,Hannaford PC

doi

10.1136/bmj.k3609

subject

Has Abstract

pub_date

2018-09-26 00:00:00

pages

k3609

eissn

0959-8138

issn

1756-1833

journal_volume

362

pub_type

杂志文章
  • Mortality of employees of the Atomic Weapons Establishment, 1951-82.

    abstract::A total of 22,552 workers employed by the Atomic Weapons Establishment between 1951 and 1982 were followed up for an average of 18.6 years. Of the 3115 who died, 865 (28%) died of cancer. Mortality was 23% lower than the national average for all causes of death and 18% lower for cancer. These low rates were consistent...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.297.6651.757

    authors: Beral V,Fraser P,Carpenter L,Booth M,Brown A,Rose G

    更新日期:1988-09-24 00:00:00

  • Prescription of oxygen concentrators for long term oxygen treatment: reassessment in one district.

    abstract::When oxygen concentrators became available on form FP10 in 1985 the Department of Health and Social Security issued clear guidelines for their prescription for long term treatment. Reassessment of those patients prescribed a concentrator in one district showed that 29 out of 61 patients did not fulfil these criteria. ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.297.6655.1030

    authors: Walshaw MJ,Lim R,Evans CC,Hind CR

    更新日期:1988-10-22 00:00:00

  • Understanding influences on smoking in Bangladeshi and Pakistani adults: community based, qualitative study.

    abstract:OBJECTIVE:To gain detailed understanding of influences on smoking behaviour in Bangladeshi and Pakistani communities in the United Kingdom to inform the development of effective and culturally acceptable smoking cessation interventions. DESIGN:Qualitative study using community participatory methods, purposeful samplin...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.326.7396.962

    authors: Bush J,White M,Kai J,Rankin J,Bhopal R

    更新日期:2003-05-03 00:00:00

  • Retention in the British National Health Service of medical graduates trained in Britain: cohort studies.

    abstract:OBJECTIVE:To report the percentage of graduates from British medical schools who eventually practise medicine in the British NHS. DESIGN:Cohort studies using postal questionnaires, employment data, and capture-recapture analysis. SETTING:Great Britain. SUBJECTS:32 430 graduates from all British medical schools in ni...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.b1977

    authors: Goldacre MJ,Davidson JM,Lambert TW

    更新日期:2009-06-03 00:00:00

  • Efficacy of lipid lowering drug treatment for diabetic and non-diabetic patients: meta-analysis of randomised controlled trials.

    abstract:OBJECTIVE:To evaluate the clinical benefit of lipid lowering drug treatment in patients with and without diabetes mellitus, for primary and secondary prevention. DESIGN:Systematic review and meta-analysis. DATA SOURCES:Cochrane, Medline, Embase, and reference lists up to April 2004. STUDY SELECTION:Randomised, place...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.38793.468449.AE

    authors: Costa J,Borges M,David C,Vaz Carneiro A

    更新日期:2006-05-13 00:00:00

  • Science, medicine, and the future. Lung cancer.

    abstract::Lung cancer, the most prevalent cancer in the Western world, is mainly caused by smoking. Nevertheless, only 20% of smokers develop lung cancer and while prevention is important, environmental factors are expected to contribute to the predicted rise in the incidence of lung cancer in the next 25 years. Survival of lun...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.314.7081.652

    authors: Sethi T

    更新日期:1997-03-01 00:00:00

  • Prevention of mother to child transmission of HIV: evaluation of a pilot programme in a district hospital in rural Zimbabwe.

    abstract:PROBLEM:Zimbabwe has one of the highest rates of HIV seroprevalence in the world. In 2001 only 4% of women and children in need of services for prevention of mother to child transmission of HIV were receiving them. DESIGN:Pilot implementation of the first programme for prevention of mother to child transmission of HIV...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.329.7475.1147

    authors: Perez F,Orne-Gliemann J,Mukotekwa T,Miller A,Glenshaw M,Mahomva A,Dabis F

    更新日期:2004-11-13 00:00:00

  • Prevalence of asthma in Finnish young men.

    abstract:OBJECTIVE:To determine the prevalence of asthma in cohorts of Finnish young men in the period 1926-89. DESIGN:A retrospective analysis using reports and statistics of Finnish defence forces. SETTING:Call up examinations of candidates for military conscription and examination of conscripts discharged because of poor h...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.301.6746.266

    authors: Haahtela T,Lindholm H,Björkstén F,Koskenvuo K,Laitinen LA

    更新日期:1990-08-04 00:00:00

  • The earliest days of first aid.

    abstract::First aid, as a profession in its own right, has a history of only 120 years. It evolved from the teachings of the Royal Humane Society and military surgeons, who saw the wisdom of training in splinting and bandaging for battlefield wounds. In 1878 two Aberdeenshire military officers, Surgeon-Major Peter Shepherd of t...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 传,历史文章,杂志文章

    doi:10.1136/bmj.309.6970.1718

    authors: Pearn J

    更新日期:1994-12-24 00:00:00

  • Randomised crossover trial of transdermal fentanyl and sustained release oral morphine for treating chronic non-cancer pain.

    abstract:OBJECTIVES:To compare patients' preference for transdermal fentanyl or sustained release oral morphine, their level of pain control, and their quality of life after treatment. DESIGN:Randomised, multicentre, international, open label, crossover trial. SETTING:35 centres in Belgium, Canada, Denmark, Finland, the Unite...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.322.7295.1154

    authors: Allan L,Hays H,Jensen NH,de Waroux BL,Bolt M,Donald R,Kalso E

    更新日期:2001-05-12 00:00:00

  • Randomised controlled trial comparing effectiveness and acceptability of an early discharge, hospital at home scheme with acute hospital care.

    abstract:OBJECTIVE:To compare effectiveness and acceptability of early discharge to a hospital at home scheme with that of routine discharge from acute hospital. DESIGN:Pragmatic randomised controlled trial. SETTING:Acute hospital wards and community in north of Bristol, with a catchment population of about 224 000 people. S...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.316.7147.1796

    authors: Richards SH,Coast J,Gunnell DJ,Peters TJ,Pounsford J,Darlow MA

    更新日期:1998-06-13 00:00:00

  • Should fertile people have access to in vitro fertilisation?

    abstract::Some existing laws and some proposed legislation regulating the practice of in vitro fertilization (IVF) limit its availability to infertile couples. Dawson and Singer question whether it is reasonable to so restrict access to IVF, and examine some of the medical and social circumstances in which IVF and the related ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.300.6718.167

    authors: Dawson K,Singer P

    更新日期:1990-01-20 00:00:00

  • Accuracy of UK Rapid Test Consortium (UK-RTC) "AbC-19 Rapid Test" for detection of previous SARS-CoV-2 infection in key workers: test accuracy study.

    abstract:OBJECTIVE:To assess the accuracy of the AbC-19 Rapid Test lateral flow immunoassay for the detection of previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN:Test accuracy study. SETTING:Laboratory based evaluation. PARTICIPANTS:2847 key workers (healthcare staff, fire and rescue of...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.m4262

    authors: Mulchandani R,Jones HE,Taylor-Phillips S,Shute J,Perry K,Jamarani S,Brooks T,Charlett A,Hickman M,Oliver I,Kaptoge S,Danesh J,Di Angelantonio E,Ades AE,Wyllie DH,EDSAB-HOME and COMPARE Investigators.

    更新日期:2020-11-11 00:00:00

  • Cost effectiveness of lowering cholesterol concentration with statins in patients with and without pre-existing coronary heart disease: life table method applied to health authority population.

    abstract:OBJECTIVES:To estimate the cost effectiveness of statins in lowering serum cholesterol concentration in people at varying risk of fatal cardiovascular disease and to explore the implications of changing the criteria for intervention on cost and cost effectiveness for a purchasing authority. DESIGN:A life table method ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.312.7044.1443

    authors: Pharoah PD,Hollingworth W

    更新日期:1996-06-08 00:00:00

  • Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review and meta-analyses.

    abstract:OBJECTIVES:To evaluate the evidence for strategies to prevent falls or fractures in residents in care homes and hospital inpatients and to investigate the effect of dementia and cognitive impairment. DESIGN:Systematic review and meta-analyses of studies grouped by intervention and setting (hospital or care home). Meta...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.39049.706493.55

    authors: Oliver D,Connelly JB,Victor CR,Shaw FE,Whitehead A,Genc Y,Vanoli A,Martin FC,Gosney MA

    更新日期:2007-01-13 00:00:00

  • Behavioural counselling to increase consumption of fruit and vegetables in low income adults: randomised trial.

    abstract:OBJECTIVE:To measure the effect of brief behavioural counselling in general practice on patients' consumption of fruit and vegetables in adults from a low income population. DESIGN:Parallel group randomised controlled trial. SETTING:Primary health centre in a deprived, ethnically mixed inner city area. PARTICIPANTS:...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.326.7394.855

    authors: Steptoe A,Perkins-Porras L,McKay C,Rink E,Hilton S,Cappuccio FP

    更新日期:2003-04-19 00:00:00

  • Incidence of cancer among Finnish airline cabin attendants, 1967-92.

    abstract:OBJECTIVE:To assess whether occupational exposure among commercial airline cabin attendants are associated with risk of cancer. DESIGN:Record linkage study. SETTING:Finland. SUBJECTS-1577 female and 187 male cabin attendants who had worked for the Finnish airline companies. MAIN OUTCOME MEASURE:Standardised incidenc...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.311.7006.649

    authors: Pukkala E,Auvinen A,Wahlberg G

    更新日期:1995-09-09 00:00:00

  • Predictors of severe H1N1 infection in children presenting within Pediatric Emergency Research Networks (PERN): retrospective case-control study.

    abstract:OBJECTIVE:To identify historical and clinical findings at emergency department presentation associated with severe H1N1 outcome in children presenting with influenza-like illness. DESIGN:Multicentre retrospective case-control study. SETTING:79 emergency departments of hospitals associated with the Pediatric Emergency...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.f4836

    authors: Dalziel SR,Thompson JM,Macias CG,Fernandes RM,Johnson DW,Waisman Y,Cheng N,Acworth J,Chamberlain JM,Osmond MH,Plint A,Valerio P,Black KJ,Fitzpatrick E,Newton AS,Kuppermann N,Klassen TP,Pediatric Emergency Research Netwo

    更新日期:2013-08-12 00:00:00

  • Avoidable waste of research related to inadequate methods in clinical trials.

    abstract:OBJECTIVE:To assess the waste of research related to inadequate methods in trials included in Cochrane reviews and to examine to what extent this waste could be avoided. A secondary objective was to perform a simulation study to re-estimate this avoidable waste if all trials were adequately reported. DESIGN:Methodolog...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.h809

    authors: Yordanov Y,Dechartres A,Porcher R,Boutron I,Altman DG,Ravaud P

    更新日期:2015-03-24 00:00:00

  • Genetically determined factors as predictors of radiological change in patients with early symmetrical arthritis.

    abstract:OBJECTIVE:To determine whether genetic factors associated with established rheumatoid arthritis could, in combination with rheumatoid factor, predict the development of radiological erosions in patients with early symmetrical (rheumatoid-like) arthritis. DESIGN:Prospective study. SETTING:Teaching hospital, early arth...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.305.6866.1387

    authors: Emery P,Salmon M,Bradley H,Wordsworth P,Tunn E,Bacon PA,Waring R

    更新日期:1992-12-05 00:00:00

  • Effect of revealing authors' conflicts of interests in peer review: randomized controlled trial.

    abstract:OBJECTIVE:To assess the effect of disclosing authors' conflict of interest declarations to peer reviewers at a medical journal. DESIGN:Randomized controlled trial. SETTING:Manuscript review process at the Annals of Emergency Medicine. PARTICIPANTS: Reviewers (n=838) who reviewed manuscripts submitted between 2 June 2...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,随机对照试验

    doi:10.1136/bmj.l5896

    authors: John LK,Loewenstein G,Marder A,Callaham ML

    更新日期:2019-11-06 00:00:00

  • Prospective randomised study of an orthopaedic geriatric inpatient service.

    abstract::A randomised controlled trial of two management regimens was carried out in women patients over 65 years of age with hip fractures. Ninety seven patients were admitted to a designated orthopaedic geriatric unit and 125 to orthopaedic wards. No difference was observed in mortality, length of stay, or placement of patie...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.297.6656.1116

    authors: Gilchrist WJ,Newman RJ,Hamblen DL,Williams BO

    更新日期:1988-10-29 00:00:00

  • Screening for cervical intraepithelial neoplasia in north east Scotland shows fall in incidence and mortality from invasive cancer with concomitant rise in preinvasive disease.

    abstract:OBJECTIVE:To assess the effect of screening for cervical intraepithelial neoplasia on the incidence of and mortality from invasive squamous cell carcinoma of cervix in north east Scotland and to discover why cases of invasive cancer still occur. DESIGN:(a) Analysis of data on cases of cervical intraepithelial neoplasi...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.308.6941.1407

    authors: Macgregor JE,Campbell MK,Mann EM,Swanson KY

    更新日期:1994-05-28 00:00:00

  • The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials.

    abstract:OBJECTIVE:To determine the effectiveness of exercise as an intervention in the management of depression. DESIGN:Systematic review and meta-regression analysis of randomised controlled trials obtained from five electronic databases (Medline, Embase, Sports Discus, PsycLIT, Cochrane Library) and through contact with exp...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.322.7289.763

    authors: Lawlor DA,Hopker SW

    更新日期:2001-03-31 00:00:00

  • Twins and maternal smoking: ordeals for the fetal origins hypothesis? A cohort study.

    abstract:OBJECTIVE:To assess the direct and indirect effects of being a twin, maternal smoking, birth weight, and mother's height on blood pressure at ages 9 and 18 years. DESIGN:Longitudinal study. SUBJECTS:Cohort born in 1972-3. SETTING:Dunedin, New Zealand. MAIN OUTCOME MEASURE:Blood pressure at ages 9 and 18 years. RES...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.318.7188.897

    authors: Williams S,Poulton R

    更新日期:1999-04-03 00:00:00

  • Association between hormone replacement therapy and subsequent stroke: a meta-analysis.

    abstract:OBJECTIVES:To review completed trials assessing effect of hormone replacement therapy on subsequent risk of stroke, assessing stroke by pathological type, severity, and outcome. DESIGN:Systematic review of randomised controlled trials identified from the Cochrane Library, Embase, and Medline; reviews; and reference li...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1136/bmj.38331.655347.8F

    authors: Bath PM,Gray LJ

    更新日期:2005-02-12 00:00:00

  • Incidence of gastric cancer among patients with gastric precancerous lesions: observational cohort study in a low risk Western population.

    abstract:OBJECTIVE:To accurately measure the incidence of gastric cancer among patients with gastric precancerous lesions, and to quantify the excess incidence in comparison with people with normal mucosa on endoscopy and a general population. DESIGN:Population based cohort study. SETTING:Population of Sweden using data from ...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.h3867

    authors: Song H,Ekheden IG,Zheng Z,Ericsson J,Nyrén O,Ye W

    更新日期:2015-07-27 00:00:00

  • Randomised trial of heroin maintenance programme for addicts who fail in conventional drug treatments.

    abstract:OBJECTIVE:To evaluate an experimental heroin maintenance programme. DESIGN:Randomised trial. SETTING:Outpatient clinic in Geneva, Switzerland. SUBJECTS:Heroin addicts recruited from the community who were socially marginalised and in poor health and had failed in at least two previous drug treatments. INTERVENTION:...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/bmj.317.7150.13

    authors: Perneger TV,Giner F,del Rio M,Mino A

    更新日期:1998-07-04 00:00:00

  • Prediction model to estimate presence of coronary artery disease: retrospective pooled analysis of existing cohorts.

    abstract:OBJECTIVES:To develop prediction models that better estimate the pretest probability of coronary artery disease in low prevalence populations. DESIGN:Retrospective pooled analysis of individual patient data. SETTING:18 hospitals in Europe and the United States. PARTICIPANTS:Patients with stable chest pain without ev...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.e3485

    authors: Genders TS,Steyerberg EW,Hunink MG,Nieman K,Galema TW,Mollet NR,de Feyter PJ,Krestin GP,Alkadhi H,Leschka S,Desbiolles L,Meijs MF,Cramer MJ,Knuuti J,Kajander S,Bogaert J,Goetschalckx K,Cademartiri F,Maffei E,Martini

    更新日期:2012-06-12 00:00:00

  • Drug injection and HIV prevalence in inmates of Glenochil prison.

    abstract:OBJECTIVE:To determine prevalence of HIV infection and drug injecting behaviour among inmates of Glenochil Prison on a specified date a year after an outbreak of hepatitis B and HIV infection. DESIGN:Cross sectional: voluntary, anonymous HIV salivary antibody surveillance and linked self completion questionnaire on ri...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.310.6975.293

    authors: Gore SM,Bird AG,Burns SM,Goldberg DJ,Ross AJ,Macgregor J

    更新日期:1995-02-04 00:00:00