Hormonal contraceptive use and risk of glioma among younger women: a nationwide case-control study

TY - JOUR

T1 - Hormonal contraceptive use and risk of glioma among younger women

T2 - a nationwide case-control study

AU - Andersen, Lene

AU - Friis, Søren

AU - Hallas, Jesper

AU - Ravn, Pernille

AU - Kristensen, Bjarne W

AU - Gaist, David

N1 - © 2014 The British Pharmacological Society.

PY - 2015/4

Y1 - 2015/4

N2 - Aim Oral contraceptive use influences the risk for certain cancers. However, few studies have examined any link with risk of central nervous system tumours. We investigated the association between hormonal contraceptive use and glioma risk among premenopausal women in a population-based setting. Methods Using national administrative and health registries in Denmark to conduct a nationwide case-control study, we identified all women ages 15 to 49 years with a first time diagnosis of histologically verified glioma between 2000 and 2009. Each case was age-matched to eight population controls using risk set sampling. Based on prescription data, exposure until 2 years prior to the index date was categorized according to hormonal contraceptive type, i.e. combined oestrogen-progestagen or progestagen only, and duration of use (<1, 1 to <5, ≥5 years). We used conditional logistic regression to compute odds ratios (ORs) with 95% confidence intervals (CIs) for glioma associated with hormonal contraceptive use, adjusting for potential confounders. Results We identified 317 cases and 2126 controls. Ever use of hormonal contraceptive was associated with an OR of 1.5 (95% CI 1.2, 2.0) and the OR increased with duration of use (long term, ≥5 years: OR 1.9; 95% CI 1.2, 2.9). The association between long term hormonal contraceptive use and glioma risk was most pronounced for progestagen only therapy (OR 2.4; 95% CI 1.1, 5.1), especially when this regimen constituted the sole hormonal contraceptive therapy (OR 4.1; 95% CI 0.8, 20.8). Conclusion Long term hormonal contraceptive use may increase the risk of glioma.

AB - Aim Oral contraceptive use influences the risk for certain cancers. However, few studies have examined any link with risk of central nervous system tumours. We investigated the association between hormonal contraceptive use and glioma risk among premenopausal women in a population-based setting. Methods Using national administrative and health registries in Denmark to conduct a nationwide case-control study, we identified all women ages 15 to 49 years with a first time diagnosis of histologically verified glioma between 2000 and 2009. Each case was age-matched to eight population controls using risk set sampling. Based on prescription data, exposure until 2 years prior to the index date was categorized according to hormonal contraceptive type, i.e. combined oestrogen-progestagen or progestagen only, and duration of use (<1, 1 to <5, ≥5 years). We used conditional logistic regression to compute odds ratios (ORs) with 95% confidence intervals (CIs) for glioma associated with hormonal contraceptive use, adjusting for potential confounders. Results We identified 317 cases and 2126 controls. Ever use of hormonal contraceptive was associated with an OR of 1.5 (95% CI 1.2, 2.0) and the OR increased with duration of use (long term, ≥5 years: OR 1.9; 95% CI 1.2, 2.9). The association between long term hormonal contraceptive use and glioma risk was most pronounced for progestagen only therapy (OR 2.4; 95% CI 1.1, 5.1), especially when this regimen constituted the sole hormonal contraceptive therapy (OR 4.1; 95% CI 0.8, 20.8). Conclusion Long term hormonal contraceptive use may increase the risk of glioma.

KW - Adolescent

KW - Adult

KW - Brain Neoplasms

KW - Case-Control Studies

KW - Contraceptives, Oral, Hormonal

KW - Denmark

KW - Female

KW - Glioma

KW - Humans

KW - Middle Aged

KW - Odds Ratio

KW - Risk

KW - Young Adult

U2 - 10.1111/bcp.12535

DO - 10.1111/bcp.12535

M3 - Journal article

C2 - 25345919

SN - 0306-5251

VL - 79

SP - 677

EP - 684

JO - British Journal of Clinical Pharmacology

JF - British Journal of Clinical Pharmacology

IS - 4

ER -