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

Sedrah Arif Butt (Corresponding Author), Øjvind Lidegaard, Charlotte W. Skovlund, Philip Hannaford, Lisa Iversen, Shona Fielding, Lina S. Mørch

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Abstract

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.
Original languageEnglish
Article number0206358
Pages (from-to)1-8
Number of pages8
JournalPloS ONE
Volume13
Issue number10
DOIs
Publication statusPublished - 30 Oct 2018

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pancreatic neoplasms
contraceptives
Contraceptive Agents
cohort studies
Pancreatic Neoplasms
contraception
Cohort Studies
Contraception
menopause
Progestins
progestational hormones
Denmark
relative risk
neoplasms
Registries
confidence interval
polycystic ovary syndrome
Confidence Intervals
Neoplasms
Private Hospitals

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Hormonal contraceptive use and risk of pancreatic cancer : A cohort study among premenopausal women. / Butt, Sedrah Arif (Corresponding Author); Lidegaard, Øjvind; Skovlund, Charlotte W.; Hannaford, Philip; Iversen, Lisa; Fielding, Shona; Mørch, Lina S.

In: PloS ONE, Vol. 13, No. 10, 0206358, 30.10.2018, p. 1-8.

Research output: Contribution to journalArticle

Butt, Sedrah Arif ; Lidegaard, Øjvind ; Skovlund, Charlotte W. ; Hannaford, Philip ; Iversen, Lisa ; Fielding, Shona ; Mørch, Lina S. / Hormonal contraceptive use and risk of pancreatic cancer : A cohort study among premenopausal women. In: PloS ONE. 2018 ; Vol. 13, No. 10. pp. 1-8.
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abstract = "ImportanceThe 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.ObjectiveTo determine whether hormonal contraception increases the risk of developing pancreatic cancer in pre-menopausal women.DesignA 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.SettingPopulation-based cohort study.ParticipantsAll 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.ResultsAmong 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 relevanceCompared 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.",
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note = "Drs. M{\o}rch and Lidegaard were supported by a grant (No 11645) from the Novo Nordisk Foundation. The funder had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the paper; or in the decision to submit the paper for publication. Correction: Hormonal contraceptive use and risk of pancreatic cancer—A cohort study among premenopausal women; Sedrah Arif Butt, {\O}jvind Lidegaard, Charlotte Skovlund, Philip C. Hannaford, Lisa Iversen, Shona Fielding, Lina Steinrud M{\o}rch; PLOS, Published: March 28, 2019, https://doi.org/10.1371/journal.pone.0214771",
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T2 - A cohort study among premenopausal women

AU - Butt, Sedrah Arif

AU - Lidegaard, Øjvind

AU - Skovlund, Charlotte W.

AU - Hannaford, Philip

AU - Iversen, Lisa

AU - Fielding, Shona

AU - Mørch, Lina S.

N1 - Drs. Mørch and Lidegaard were supported by a grant (No 11645) from the Novo Nordisk Foundation. The funder had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the paper; or in the decision to submit the paper for publication. Correction: Hormonal contraceptive use and risk of pancreatic cancer—A cohort study among premenopausal women; Sedrah Arif Butt, Øjvind Lidegaard, Charlotte Skovlund, Philip C. Hannaford, Lisa Iversen, Shona Fielding, Lina Steinrud Mørch; PLOS, Published: March 28, 2019, https://doi.org/10.1371/journal.pone.0214771

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N2 - ImportanceThe 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.ObjectiveTo determine whether hormonal contraception increases the risk of developing pancreatic cancer in pre-menopausal women.DesignA 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.SettingPopulation-based cohort study.ParticipantsAll 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.ResultsAmong 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 relevanceCompared 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 - ImportanceThe 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.ObjectiveTo determine whether hormonal contraception increases the risk of developing pancreatic cancer in pre-menopausal women.DesignA 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.SettingPopulation-based cohort study.ParticipantsAll 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.ResultsAmong 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 relevanceCompared 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.

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