American Journal of Epidemiology Vol. 152, No. 3 : 233-241
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Risk of Ovarian Cancer in Relation to Estrogen and Progestin Dose and Use Characteristics of Oral Contraceptives
1 Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
2 Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA.
3 Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL.
4 Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA.
5 Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA.
Although past studies have shown that oral contraceptives with 50 µg or more of estrogen reduce the risk of ovarian cancer, it is not clear whether newer, lower-dose formulations do as well. We conducted a population-based, case-control study in the Delaware Valley to assess the impact of dose of oral contraception on risk of ovarian cancer. Cases aged 20–69 years with a diagnosis of epithelial ovarian cancer ascertained between May 1994 and July 1999 (n = 767) were compared with community controls (n = 1,367). Compared with never users, the adjusted risk of ovarian cancer was reduced by 40% for oral contraceptive users overall, with longer duration of use affording greater protection. The ovarian cancer risk reduction was similar for women who initiated oral contraception before 1972, when high-dose pills dominated the market; between 1972 and 1980; and after 1980, when newer, lower-dose pills dominated. Oral contraceptive estrogen and progestin content were compared for cases and controls after adjustment for current age, number of pregnancies, race, and family history of ovarian cancer. Use of low-estrogen/low-progestin pills afforded an estimated risk reduction (odds ratio = 0.5, 95% confidence interval: 0.3, 0.6) that was identical to that for high-estrogen/high-progestin pills (odds ratio = 0.5, 95% confidence interval: 0.3, 0.7). Am J Epidemiol 2000;152:233–41.
contraceptives; oral; estrogens; ovarian neoplasms; progestational hormones
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