Oral contraceptives may reduce risk of death from any cause in women.

Moral of the story: Oral contraceptives decrease risk of death

Source: AMA Morning Rounds 3/12/2010, BMJ Press Release 3/12/2010

(4) Contraceptive pill not associated with increased long-term risk of death
(Research: Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners' Oral Contraception Study)
http://www.bmj.com/cgi/content/full/340/mar11_1/c927
Women in the UK who have ever used the oral contraceptive pill are less likely to die from any cause, including all cancers and heart disease, compared with never users, according to research published on bmj.com today.
The results show a slightly higher risk in women under 45 years old who are current or recent users of the pill. The authors stress that the effects in younger women disappear after about 10 years. Furthermore, the benefits in older women outweigh the smaller excess risks among younger women.
The study continues to find a higher rate of violent or accidental death among oral contraceptive users compared with never users. The authors are unable to explain this persistent finding.
In May 1968, the Royal College of General Practitioners' (RCGP) began the RCGP Oral Contraception Study, one of the world’s largest continuing investigations into the health effects of oral contraceptives.
Early reports from the RCGP study suggested an increased risk of death among oral contraceptive users, mainly due to an excess of strokes or other vascular problems among older women or those who smoked. Although a later report suggested that these effects disappear once the pill is stopped, at the time there were relatively few cases of different types of cancer.
These latest results, led by Professor Philip Hannaford from the University of Aberdeen, relate to the 46,000 recruited women, followed for up to nearly 40 years, creating more than a million woman-years of observation.
The results show that in the longer term, women who used oral contraception had a significantly lower rate of death from any cause, including heart disease and all cancers (notably bowel, uterine body and ovarian cancers) compared with never users.
This equates to 52 fewer deaths per 100,000 woman-years.
Slightly higher rates were found among younger women who had used oral contraception, with 20 more deaths per 100,000 among those younger than 30, and four more deaths per 100,000 among 30-39 year olds.
But by the age of 50, the benefits outweighed these modest risks, with 14 fewer deaths per 100,000 among 40-49 year olds; 86 fewer deaths per 100,000 for 50-59 year olds; 122 fewer deaths per 100,000 for 60-69 year olds; and 308 fewer deaths per 100,000 for 70+ year olds.
Hannaford says: "Many women, especially those who used the first generation of oral contraceptives many years ago, are likely to be reassured by our results. However, our findings might not reflect the experience of women using oral contraceptives today, if currently available preparations have a different risk than earlier products."
The authors conclude that their results, derived from a relatively healthy UK study group, show that "oral contraception is not significantly associated with an increased long-term risk of death . . . indeed a net benefit was apparent." However, they point out that "the balance of risks and benefits may vary globally, depending upon patterns of oral contraception usage and background risk of disease."
Contact:
Philip Hannaford, Centre of Academic Primary Care, University of Aberdeen, Scotland
Email p.hannaford@abdn.ac.uk

Oral contraceptives may reduce risk of death from any cause in women.

Bloomberg News (3/12, Cortez) reports that, according to findings published in the British Medical Journal, women who use oral contraceptives "were less likely to die of heart disease, cancer, or a range of other medical ailments." In fact, "women who took the pill were 12 percent less likely to die from any cause during the study." The study also showed that "the risk of death was slightly higher in women under age 45 who were current or recent users, though it abated after 10 years." Data indicated that "overall, there were 52 fewer deaths than expected for every 100,000 women taking the pill each year."

        MedPage Today (3/11, Fiore) reports that researchers "found lower rates of death from circulatory disease, ischemic heart disease, and other disease among women who'd used birth control pills," as well as "all cancers." Notably, "women on the pill did have higher rates of violent deaths," but "the researcher said they had no explanation for this association."