Hormonal contraceptive use and risk of pancreatic cancer-A cohort study among premenopausal women
Hormonal contraceptive use and risk of pancreatic cancer-A cohort study among premenopausal women
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DOI：
10.1371/journal.pone.0206358
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发表时间：
2018-10-30
期刊：
影响因子：
3.7
通讯作者：
Morch, Lina Steinrud
中科院分区：
文献类型：
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作者：
Butt, Sedrah Arif;Lidegaardi, Ojvind;Morch, Lina Steinrud
在绝经前妇女中使用激素避孕药与胰腺癌之间的关系到目前为止还不清楚。这是第一个调查绝经前妇女患胰腺癌风险的研究。目的探讨激素避孕是否会增加绝经前妇女患胰腺癌的风险。DesignA是一项全国性的前瞻性队列研究，研究对象是1995年至2014年期间，年龄在15-49岁之间、既往无癌症或静脉血栓形成的丹麦所有女性。丹麦国家处方登记处提供了关于使用激素避孕的个人最新暴露信息。丹麦癌症登记处提供癌症诊断，丹麦国家病人登记册载有从公立和私立医院出院时的临床诊断和手术代码。以人群为基础的队列研究。参与者：1995年1月1日居住在丹麦的所有15-49岁的女性，以及随后到2014年12月31日年满15岁的女性都有资格参加这项研究。结果在平均随访11.4年的190万名女性中，发生了235例胰腺癌。与从未使用过激素避孕的患者相比，曾经使用过任何类型激素避孕的患者胰腺癌的相对风险（RR）为0.90（95%可信区间（CI） 0.68-1.19）。没有发现激素避孕药使用时间与胰腺癌风险之间的总体关联。长期使用激素避孕与胰腺癌也没有相关性，RR为0.83 （95% CI 0.47-1.50）。使用联合用药和仅使用孕激素制剂的患者之间的风险没有差异。所有模型都根据年龄、已完成或正在进行的教育、多囊卵巢综合征、子宫内膜异位症和产妇进行了调整；胎次、第一胎年龄、吸烟和体重指数。结论和相关性：与从未使用过现代激素避孕药的患者相比，目前和近期使用激素避孕药的患者胰腺癌的风险没有显著升高，并且在联合使用和仅使用孕激素避孕药的患者之间没有差异。总之，我们的研究表明，使用任何类型的激素避孕都没有患胰腺癌的风险。
ImportanceThe association between the use of hormonal contraceptive and pancreatic cancer among premenopausal women has until now been unclear. This is the first study to investigate the risk of pancreatic cancer in pre-menopausal women.ObjectiveTo determine whether hormonal contraception increases the risk of developing pancreatic cancer in pre-menopausal women.DesignA nationwide prospective cohort study followed all women in Denmark in the age range of 15-49 years without previous cancer or venous thrombosis from 1995 to 2014. The Danish National Prescription Registry provided individually updated exposure information on use of hormonal contraception. The Danish Cancer Registry provided cancer diagnoses, and the Danish National Patient Register containing clinical diagnoses and surgical codes at discharge from public and private hospitals.SettingPopulation-based cohort study.ParticipantsAll women living in Denmark aged 15-49 years at January 1st, 1995, and those subsequently reaching age 15 years up to December 31st, 2014 were eligible for the study.ResultsAmong 1.9 million women who were followed on average for 11.4 years, 235 pancreatic cancers occurred. Compared to never users, ever users of any type of hormonal contraception had a relative risk (RR) of pancreatic cancer of 0.90 (95% confidence interval (CI) 0.68-1.19). No overall association between duration of hormonal contraceptive use and pancreatic cancer risk was found. Neither was long-term use of hormonal contraception associated with pancreas cancer, RR 0.83 (95% CI 0.47-1.50). The risk did not vary between users of combined and progestogen-only products. All models were adjusted for age, completed or ongoing education, polycystic ovary syndrome, endometriosis and among parous women; parity, age at first birth, smoking and body mass index.Conclusions and relevanceCompared to never users the risk of pancreatic cancer is not significantly higher among current and recent users of contemporary hormonal contraception and does not vary between users of combined and progestogen-only products. In conclusion, our study suggests no risk of pancreatic cancer with use of any type of hormonal contraception.