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American Journal of Epidemiology Advance Access published online on June 15, 2006
American Journal of Epidemiology, doi:10.1093/aje/kwj214
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.
Received November 8, 2005
Accepted February 21, 2006

ORIGINAL CONTRIBUTIONS

Mortality among Canadian Women with Cosmetic Breast Implants

Paul J. Villeneuve 1, Eric J. Holowaty 2, Jacques Brisson 3, Lin Xie 4, Anne-Marie Ugnat 4, Louis Latulippe 3, and Yang Mao 4 *

1 Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario, Canada; Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada
2 Informatics Research and Development, Cancer Care Ontario, Toronto, Ontario, Canada
3 Department of Social and Preventive Medicine, Laval University, Laval, Quebec, Canada
4 Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario, Canada

* To whom correspondence should be addressed.
Yang Mao, E-mail: Yang_Mao{at}phac-aspc.gc.ca


  Abstract

There is widespread concern about possible long-term health effects among women who have received breast implants for cosmetic purposes; few studies have reported on the mortality patterns of such women. The authors examined cause-specific mortality in a cohort of 24,558 women with breast implants and 15,893 women who underwent other plastic surgery procedures in Ontario and Quebec, Canada, between 1974 and 1989. Deaths through 1997 were identified through linkage to the national mortality database. The authors compared the mortality of women who received implants with that of the general population by using standardized mortality ratios; Poisson regression was used to perform internal cohort comparisons. Overall mortality was lower among women who received breast implants relative to the general population (standardized mortality ratio = 0.74, 95% confidence interval: 0.68, 0.81). In contrast, higher suicide rates were observed in both the implant (standardized mortality ratio = 1.73, 95% confidence interval: 1.31, 2.24) and other plastic surgery (standardized mortality ratio = 1.55, 95% confidence interval: 1.07, 2.18) patients. No differences in mortality were found between the implant and other surgeries group for any of the 20 causes of death examined. Findings suggest that breast implants do not directly increase mortality in women. Further work is needed to evaluate risk factors for suicide among women who undergo elective cosmetic surgery.

Keywords: breast implants; cohort studies; mortality; suicide.
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