Oral contraceptive use and breast cancer risk: a meta-analysis of variations with age at diagnosis, parity and total duration of oral contraceptive use
Rushton, L.; Jones, D.R.
British Journal of Obstetrics and Gynaecology 99(3): 239-246
1992
ISSN/ISBN: 0306-5456 PMID: 1534994 DOI: 10.1111/j.1471-0528.1992.tb14506.xDocument Number: 287570
27 epidemiological studies of breast cancer risk and oral contraceptive (OC) use published between 1980-89 were reviewed. A meta-analysis of study results, using regression techniques to explore the interstudy heterogeneity, was utilized. The main outcome measures examined were relative risk of breast cancer with OC use, variations by age at diagnosis, parity, and total duration of use, and those with study design characteristics. The overall risk estimate was 1.16 (95% CI 1.07-1.25) for the 45-year group, 1.21 (95% CI 0.99-1.47) for the nulliparous subgroup, and 1.27 (95% CI 1.12-1.44) for durations of use of more than 8 years. Source of subjects, their marital status, type of study, data collection methods, matching for geographical area, the number of adjustment factors used in the study analysis, the country of study, and the calendar period in which the study ended were all important explanatory factors for interstudy variation. However, a substantial proportion of interstudy variation remained unexplained. These meta-analyses suggest that the risk of breast cancer may be raised by around 20% in younger, nulliparous, and long-use duration subgroups of OC users. Risk estimates appear to be influenced by several study design factors which must be considered carefully in designing and reviewing future studies.