Oral Contraceptives and Cervical Cancer Risk in Costa Rica: Detection Bias or Causal Association
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Date
Authors
Irwin, Kathleen L.
Rosero Bixby, Luis
Oberle, Mark W.
Lee, Nancy C.
Whatley, Anne S.
Fortney, Judith A.
Bonhomme, Michele G.
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Abstract
To examine the relationship between cervical cancer and oral contraceptive
(OC) use, we analyzed data from a population-based, case-control study in
Costa Rica. Women aged 25 to 58 years in whom cervical cancer was diagnosed
and reported to the National Tumor Registry were examined as two
separate case groups: invasive cervical cancer and carcinoma in situ (CIS).
Controls were women aged 25 to 58 years identified through a national survey.
Women who had used OCs had no increased risk of invasive cervical cancer
compared with women who had never used OCs (relative risk, 0.8; 95%
confidence interval, 0.5 to 1.3). Women who had used OCs had an increased
risk of CIS compared with those who had never used OCs (relative risk, 1.6; 95%
confidence interval, 1.2 to 2.2). However, further analyses indicated that this
increased risk was confined to those who had recently used OCs. Also, the risk
of CIS was not elevated in subgroups in which a history of cervical smears was
not strongly linked to OC use. The elevated risk of CIS among (DC users may
therefore reflect a bias caused by enhanced detection of disease rather than a
causal association.
Description
Artículo científico -- Universidad de Costa Rica. Instituto de Investigaciones en Salud, 1988
Keywords
Costa Rica, cervical cancer, oral contraceptive
Citation
http://www.roserobixby.com/RoseroBixby/Publicaciones_files/101.pdf
http://jama.jamanetwork.com/article.aspx?articleid=370061
http://jama.jamanetwork.com/article.aspx?articleid=370061