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首页> 外文期刊>The Lancet >Cervical cancer and hormonal contraceptives: collaborative reanalysis of individual data for 16,573 women with cervical cancer and 35,509 women without cervical cancer from 24 epidemiological studies.
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Cervical cancer and hormonal contraceptives: collaborative reanalysis of individual data for 16,573 women with cervical cancer and 35,509 women without cervical cancer from 24 epidemiological studies.

机译：宫颈癌和激素避孕药：根据24项流行病学研究，对16573例宫颈癌妇女和35509例无宫颈癌妇女的个体数据进行了合作的重新分析。

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BACKGROUND: Combined oral contraceptives are classified by the International Agency for Research on Cancer as a cause of cervical cancer. As the incidence of cervical cancer increases with age, the public-health implications of this association depend largely on the persistence of effects long after use of oral contraceptives has ceased. Information from 24 studies worldwide is pooled here to investigate the association between cervical carcinoma and pattern of oral contraceptive use. METHODS: Individual data for 16,573 women with cervical cancer and 35,509 without cervical cancer were reanalysed centrally. Relative risks of cervical cancer were estimated by conditional logistic regression, stratifying by study, age, number of sexual partners, age at first intercourse, parity, smoking, and screening. FINDINGS: Among current users of oral contraceptives the risk of invasive cervical cancer increased with increasing duration of use (relative risk for 5 or more years' use versus never use, 1.90 [95% CI 1.69-2.13]). The risk declined after use ceased, and by 10 or more years had returned to that of never users. A similar pattern of risk was seen both for invasive and in-situ cancer, and in women who tested positive for high-risk human papillomavirus. Relative risk did not vary substantially between women with different characteristics. INTERPRETATION: The relative risk of cervical cancer is increased in current users of oral contraceptives and declines after use ceases. 10 years' use of oral contraceptives from around age 20 to 30 years is estimated to increase the cumulative incidence of invasive cervical cancer by age 50 from 7.3 to 8.3 per 1000 in less developed countries and from 3.8 to 4.5 per 1000 in more developed countries.
机译：背景：联合口服避孕药被国际癌症研究机构归类为宫颈癌的病因。随着宫颈癌的发病率随着年龄的增长而增加，这种协会的公共卫生影响在很大程度上取决于口服避孕药停止使用后很长时间的持久性。这里汇总了来自全球24项研究的信息，以研究宫颈癌与口服避孕药使用方式之间的关联。方法：对16573例宫颈癌妇女和35509例无宫颈癌妇女的个人数据进行集中分析。宫颈癌的相对风险通过条件逻辑回归，研究，年龄，性伴侣数量，初次性交年龄，均等，吸烟和筛查进行分层。结果：在目前使用口服避孕药的使用者中，浸润性宫颈癌的风险随着使用时间的延长而增加（使用5年或以上与未使用的相对风险为1.90 [95％CI 1.69-2.13]）。停止使用后风险降低，到10年或更久的时间才恢复为从未使用过的风险。对于浸润性和原位癌以及在高危人乳头瘤病毒检测呈阳性的女性中，均观察到类似的风险模式。具有不同特征的女性之间的相对风险没有很大的不同。解释：当前口服避孕药的使用者宫颈癌的相对风险增加，并且在停止使用后下降。据估计，从20岁到30岁使用口服避孕药10年，到50岁时，在较不发达国家中，浸润性宫颈癌的累积发病率将从每千人7.3增至8.3，而在较发达国家则从每千人3.8增至4.5。

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