Contraception methods, beyond oral contraceptives and tubal ligation, and risk of ovarian cancer.
Contraception methods, beyond oral contraceptives and tubal ligation, and risk of ovarian cancer.
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DOI：
10.1016/j.annepidem.2010.10.002
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发表时间：
2011-03
影响因子：
5.6
通讯作者：
Moysich, Kirsten B.
中科院分区：
文献类型：
--
作者：
Ness, Roberta B.;Dodge, Rhiannon C.;Edwards, Robert P.;Baker, Julie A.;Moysich, Kirsten B.
除了口服避孕药（OCs）和输卵管结扎外，很少有研究调查避孕方法与卵巢癌风险的关系。992例卵巢/腹膜/输卵管癌病例与1800例以人群为基础的对照进行了比较。女性使用生活日历自行报告所有避孕方法。与不使用人工避孕相比，每一种避孕方法都降低了患卵巢癌的风险。在对潜在的混杂因素和所有其他避孕方法进行调整后，比较曾经使用过和从未使用过的避孕方法，具有保护作用的避孕方法是口服避孕药（adj OR 0.75, 95% CI 0.61-0.93）；输卵管结扎（adj OR 0.63, 95% CI 0.51-0.77）；宫内节育器（iud） （adj OR 0.75, 95% CI 0.59-0.95）；输精管切除术（adj OR 0.77, 95% CI 0.61-0.99）。对于口服避孕药和输卵管结扎，使用时间越长，效果越好，而对于宫内节育器，情况正好相反：使用时间越短，保护作用显著，使用时间越长，风险逐渐增加（尽管不显著）。在迄今为止最大的病例对照研究中，一系列有效的避孕方法降低了患卵巢癌的风险。宫内节育器使用时间越长，降低卵巢癌风险的比值比越低，而宫内节育器总体上降低风险，使用时间越短影响最大。
Few studies have examined methods of contraception, beyond oral contraceptives (OCs) and tubal ligation, in relation to ovarian cancer risk. Nine hundred two cases with incident ovarian/peritoneal/tubal cancer were compared to 1800 population-based controls. Women self-reported all methods of contraception using life calendars. Each of the contraceptive methods examined reduced the risk of ovarian cancer as compared to use of no artificial contraception. Comparing ever versus never use, after adjustment for potentially confounding factors and all other methods of contraception, the methods of contraception that emerged as protective were OCs (adj OR 0.75, 95% CI 0.61–0.93); tubal ligation (adj OR 0.63, 95% CI 0.51–0.77); intrauterine devices (IUDs) (adj OR 0.75, 95% CI 0.59–0.95); and vasectomy (adj OR 0.77, 95% CI 0.61–0.99). While for oral contraceptives and tubal ligation, the longer the duration of use, the greater the effect, for IUDs the pattern was reversed: significant protection occurred with short duration and progressively greater risk (albeit non-significant) was seen with longer duration of use. In the largest case-control study to date, a range of effective methods of contraception reduced the risk for ovarian cancer. OCs and tubal ligation reduced ovarian cancer risk with lower odds ratios with longer duration of use, whereas IUDs reduced risk overall, having the greatest impact with short duration of use.
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