Hormonal contraceptive use and risk of pancreatic cancer: A cohort study among premenopausal women

TY - JOUR

T1 - Hormonal contraceptive use and risk of pancreatic cancer

T2 - A cohort study among premenopausal women

AU - Butt, Sedrah Arif

AU - Lidegaardi, Øjvind

AU - Skovlund, Charlotte

AU - Hannaford, Philip C

AU - Iversen, Lisa

AU - Fielding, Shona

AU - Mørch, Lina Steinrud

PY - 2018/10

Y1 - 2018/10

N2 - IMPORTANCE: The association between the use of hormonal contraceptive and pancreatic cancer among premenopausal women has until now been unclear. This is the first study to investigate the risk of pancreatic cancer in pre-menopausal women.OBJECTIVE: To determine whether hormonal contraception increases the risk of developing pancreatic cancer in pre-menopausal women.DESIGN: A nationwide prospective cohort study followed all women in Denmark in the age range of 15-49 years without previous cancer or venous thrombosis from 1995 to 2014. The Danish National Prescription Registry provided individually updated exposure information on use of hormonal contraception. The Danish Cancer Registry provided cancer diagnoses, and the Danish National Patient Register containing clinical diagnoses and surgical codes at discharge from public and private hospitals.SETTING: Population-based cohort study.PARTICIPANTS: All women living in Denmark aged 15-49 years at January 1st, 1995, and those subsequently reaching age 15 years up to December 31st, 2014 were eligible for the study.RESULTS: Among 1.9 million women who were followed on average for 11.4 years, 235 pancreatic cancers occurred. Compared to never users, ever users of any type of hormonal contraception had a relative risk (RR) of pancreatic cancer of 0.90 (95% confidence interval (CI) 0.68-1.19). No overall association between duration of hormonal contraceptive use and pancreatic cancer risk was found. Neither was long-term use of hormonal contraception associated with pancreas cancer, RR 0.83 (95% CI 0.47-1.50). The risk did not vary between users of combined and progestogen-only products. All models were adjusted for age, completed or ongoing education, polycystic ovary syndrome, endometriosis and among parous women; parity, age at first birth, smoking and body mass index.CONCLUSIONS AND RELEVANCE: Compared to never users the risk of pancreatic cancer is not significantly higher among current and recent users of contemporary hormonal contraception and does not vary between users of combined and progestogen-only products. In conclusion, our study suggests no risk of pancreatic cancer with use of any type of hormonal contraception.

AB - IMPORTANCE: The association between the use of hormonal contraceptive and pancreatic cancer among premenopausal women has until now been unclear. This is the first study to investigate the risk of pancreatic cancer in pre-menopausal women.OBJECTIVE: To determine whether hormonal contraception increases the risk of developing pancreatic cancer in pre-menopausal women.DESIGN: A nationwide prospective cohort study followed all women in Denmark in the age range of 15-49 years without previous cancer or venous thrombosis from 1995 to 2014. The Danish National Prescription Registry provided individually updated exposure information on use of hormonal contraception. The Danish Cancer Registry provided cancer diagnoses, and the Danish National Patient Register containing clinical diagnoses and surgical codes at discharge from public and private hospitals.SETTING: Population-based cohort study.PARTICIPANTS: All women living in Denmark aged 15-49 years at January 1st, 1995, and those subsequently reaching age 15 years up to December 31st, 2014 were eligible for the study.RESULTS: Among 1.9 million women who were followed on average for 11.4 years, 235 pancreatic cancers occurred. Compared to never users, ever users of any type of hormonal contraception had a relative risk (RR) of pancreatic cancer of 0.90 (95% confidence interval (CI) 0.68-1.19). No overall association between duration of hormonal contraceptive use and pancreatic cancer risk was found. Neither was long-term use of hormonal contraception associated with pancreas cancer, RR 0.83 (95% CI 0.47-1.50). The risk did not vary between users of combined and progestogen-only products. All models were adjusted for age, completed or ongoing education, polycystic ovary syndrome, endometriosis and among parous women; parity, age at first birth, smoking and body mass index.CONCLUSIONS AND RELEVANCE: Compared to never users the risk of pancreatic cancer is not significantly higher among current and recent users of contemporary hormonal contraception and does not vary between users of combined and progestogen-only products. In conclusion, our study suggests no risk of pancreatic cancer with use of any type of hormonal contraception.

KW - Adolescent

KW - Adult

KW - Body Mass Index

KW - Cohort Studies

KW - Contraceptives, Oral, Hormonal/adverse effects

KW - Denmark/epidemiology

KW - Endometriosis/complications

KW - Female

KW - Humans

KW - Middle Aged

KW - Pancreatic Neoplasms/diagnosis

KW - Polycystic Ovary Syndrome/complications

KW - Premenopause

KW - Prospective Studies

KW - Registries

KW - Risk

KW - Smoking

KW - Young Adult

U2 - 10.1371/journal.pone.0206358

DO - 10.1371/journal.pone.0206358

M3 - Journal article

C2 - 30376560

SN - 1932-6203

VL - 13

JO - PLoS Computational Biology

JF - PLoS Computational Biology

IS - 10

M1 - e0206358

ER -