[避孕药的风险和益处。]对一项意大利研究结果的回顾]。

F Parazzini, C La Vecchia, E Negri
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摘要

根据1980年代初以来在意大利北部开展的病例对照研究网络的数据,审查了口服避孕药与疾病风险之间的关系,这些研究涉及约150例55岁以下急性心肌梗死、150例胆结石、350例子宫肌瘤、170例子宫内膜癌、700例良性或恶性卵巢肿瘤、2000例乳腺癌、360例上皮内癌和370例浸润性宫颈癌。20名肝癌患者加上2000多名对照组妇女因急性非激素相关非肿瘤疾病入院。目前服用者心肌梗死的相对危险度(RR)为2.1(95%可信区间从0.7到7.1),但只有4%的女性是目前的服用者。胆结石疾病、子宫肌瘤与口服避孕药的使用无相关性。子宫内膜癌和卵巢良性、交界性和恶性肿瘤均有显著的保护作用,浸润性宫颈癌的RR大于1 (RR = 1.9),而宫颈上皮内瘤变的RR不大于1。原发性肝癌的发病风险显著增加,但这在年轻女性中极为罕见。对于乳腺癌,没有一致的持续时间-风险关系,使用5年及以上的RR为0.8。因此,这些数据提供了关于o.c.使用与南欧人群中几种重要疾病风险之间关系的可靠信息。
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[Risks and benefits of the contraceptive pill. A review of the results of an Italian study].

The association between oral contraceptives (o.c.) and disease risk was reviewed on the basis of data from a network of a case-control studies conducted in northern Italy since the early 1980's on about 150 cases below age 55 with acute myocardial infarction, 150 with gallstone disease, 350 with uterine fibromyoma, 170 with endometrial cancer, 700 with benign or malignant ovarian tumours, 2000 with breast cancer, 360 with intraepithelial and 370 with invasive cervical cancer, 20 with liver cancer plus over 2000 control women admitted to hospital for acute, non hormone-related non neoplastic diseases. The relative risk (RR) of myocardial infarction was 2.1 (95% confidence interval from 0.7 to 7.1) among current o.c. users, but only 4% of women were current users. There was no association between gallstone disease, uterine fibromyoma and o.c. use. Significant protections were observed with reference to endometrial cancer and benign, borderline and malignant ovarian tumours, while the RR was above unity (RR = 1.9) for invasive cervical cancer, but not for intraepithelial cervical neoplasia. A significantly increased risk was observed for primary liver cancer, which is however extremely rare in young women. With reference to breast cancer, there was no consistent duration-risk relationship, and the RR was 0.8 for use for 5 or more years. Thus, these data provide reassuring information on the relationship between o.c. use and the risk of several important diseases in a Southern European population.

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