Oral Contraceptive Use and All-Cause Mortality: A 36-Year Study
the MPR take:
Prior research has indicated that use of oral contraceptives may lower the risk of ovarian and colorectal cancer, but could also increase myocardial infarction and ischemic stroke risk. In a prospective cohort study, 121,577 women’s lifetime oral contraceptive use was recorded biennially from 1976–1982 and followed for an average of 36 years as part of the Nurses’ Health Study. Deaths from all causes were determined using reports from families, state mortality files, and the National Death Index. 63,626 women were never users of oral contraceptives (52.3%) and 57, 951 were ever users (52.3%), with a reported mean 4.1 years duration of use. All-cause mortality did not significantly differ between women who had ever used oral contraceptives and never users, but violent or accident deaths (particularly suicide) were more common among ever-users with less than one year of use. Oral contraception use was of borderline significance for other causes of death such as breast and ovarian cancer and cerebrovascular disease. Longer duration of use had a greater association with all-cause mortality and specific causes of death including an increased risk of breast cancer but a decreased rate of ovarian cancer. These results may not be applicable to the present third and fourth generation formulations which have lower estrogen doses vs. earlier formulations (like those evaluated in this study) with higher hormone doses.
To determine whether use of oral contraceptives is associated with all cause and cause specific mortality.