Meta-analysis of oral contraceptive use and risks of all-cause and cause-specific death.

Abstract

Whether ever use of oral contraceptives (OCs) is associated with mortality remains unclear. To evaluate the association between ever use of OCs and mortality. On November 2, 2014, PubMed and Embase were searched for human studies, using the terms "contraceptive," "contraceptives," "death," and "mortality." Prospective cohort studies were included that provided risk estimates on OC use and mortality, and were reported in English or Chinese. A random-effects model was used to pool data. Random-effects meta-regression was used to determine whether duration of OC use and time since last OC use were associated with mortality. Nine studies were included. Ever use of OCs was not associated with mortality from all causes (hazard ratio [HR] 0.94; 95% CI 0.87-1.02) or breast cancer (HR 1.00; 95% CI 0.95-1.06). Neither the duration of OC use nor the time since last OC use was associated with all-cause or breast cancer mortality. In an analysis of a small number of studies, ever users were at decreased risk of mortality from ovarian cancer (HR 0.58; 95% CI 0.35-0.94). There is no significant association between ever use of OCs and mortality from all causes or breast cancer.