口服避孕药的使用和肝癌的风险:基于人口的研究,系统性审查和元分析
Cody Z Watling1, Siân Sweetland2, Aika Wojt1
1Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rochville, MD, USA.
The Lancet. Oncology
|July 5, 2025
概括
口服避孕药的使用与肝癌风险无关. 长期使用可能会略微增加风险,但需要进一步研究来排除混因素.
科学领域:
- 流行病学 流行病学
- 在瘤学瘤学.
- 生殖健康 生殖健康
背景情况:
- 以前的研究表明,口服避孕药的使用可能会增加肝癌的风险.
- 国际癌症研究机构 (IARC) 在1999年发现了足够的证据,但基于有限的病例数量.
- 这项研究旨在提供更强有力的证据,使用大型潜在的英国队列和元分析.
研究的目的:
- 调查口服避孕药 (OC) 使用与肝癌风险之间的关联.
- 对现有的关于OC使用和肝癌的观察性研究进行系统审查和元分析.
- 提供关于这种关系的最新和更可靠的流行病学证据.
主要方法:
- 来自百万妇女研究 (MWS) 和英国生物库队列的数据分析.
- 在OC使用数据中包括没有流行癌症的女性 (不包括非黑色素瘤皮肤癌).
- 对PubMed,Embase和其他数据库进行系统的文献搜索,用于观察性研究,截至2024年6月.
- 使用固定效应模型来确定相对风险 (RR) 的研究特定风险估计的聚合分析.
主要成果:
- 在MWS (HR 1.05) 或英国生物库 (HR 1.08) 中,从未使用OC与肝癌风险之间没有发现任何关联.
- 对23项研究 (5422例肝癌病例) 的分析显示,从来/从未使用过OC与肝癌之间没有关联 (RR 1.04).
- 观察到每5年使用OC的肝癌风险略有增加 (RR 1.06),包括肝细胞癌 (RR 1.07) 和肝内胆管癌 (RR 1.06).
结论:
- 从观察性研究的总体证据表明,从来/从未使用口服避孕药和肝癌之间没有联系.
- 使用口服避孕药的持续时间与肝癌或其主要亚型几乎没有关联.
- 不能排除使用时间较长的潜在微小风险增加,但残留混仍然是一个可能性.
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