American Journal of Epidemiology Vol. 139, No. 7: 654-661
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health
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A Case-Control Study of Oral Contraceptive Use and Invasive Epithelial Ovarian Cancer
1Slone Epidemiology Unit School of Public Health Boston University School of Medicine Brookline MA
2Department of Epidemiology and Biostatistics Memorial Sloan-Kettering Cancer Center New York NY
3Cancer Care and Research Program New York Hospital New York NY and Department of Public Health Cornell Medical Center New York NY
4Gynecology Service Department of Surgery Memorial Sloan-Kettering Cancer Center New York NY
5Center for Clinical Epidemiology and Biostatistics and Division of General Internal Medicine University of Pennsylvania School of Medicine Philadelphia PA
Reprint requests to Dr. Lynn Rosenberg, Slone Epidemiology Unit, 1371 Beacon Street, Brookline, MA 02146
The relation of oral contraceptive use to the risk of ovarian cancer was assessed with data collected during 1977–1991 from patients under 65 years of age in hospitals in Boston, New York, Philadelphia, and Baltimore. We compared 441 women with recently diagnosed invasive epithelial ovarian cancer to 2,065 control women. Logistic regression was used to control risk factors for ovarian cancer. The multivariate relative risk estimate decreased with the increasing duration of oral contraceptive use (p < 0.05): the estimate was close to 1.0 for duration categories of less than 3 years; it was reduced for the categories of 3–4 years of use and greater, but it did not decline further as the duration of use increased. For 
3 years of use, the estimate was 0.6 (95% confidence interval 0.4–0.8). The inverse association of risk with 3 years of use was consistently present across categories of age, parity, interview year, and geographic area. It was apparent for as long as 15–19 years after cessation. Many different specific oral contraceptive formulations appeared related to a decreased risk; however, data were sparse for the newer types, particu phasic preparations, and the ability to assess specific preparations in the context of use of multiple preparations was limited. The present data confirm previous reports of an inverse association of ovarian cancer risk with oral contraceptive use of several years in duration. They also suggest that the association may persist for as long as two decades and that it is not confined to any particular type of oral contraceptive formulation.
Contraceptives; oral; ovarian neoplasms
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