Oral contraceptive use and risk of liver cancer: a population-based study, systematic review, and meta-analysis
Notice bibliographique
Résumé
Background Oral contraceptive use has been suggested to increase the risk of liver cancer. Although the International Agency for Research on Cancer concluded in 1999 that there was sufficient evidence of an association, this was based on case–control studies with few liver cancer cases. We aimed to provide more robust epidemiological evidence on this association by analysing data from two large prospective UK cohorts and additionally conducting a systematic review and meta-analysis of previous observational studies. Methods In our population-based study, the relationship between oral contraceptive use and liver cancer risk was examined using data from the Million Women Study (MWS) and the UK Biobank. We included women from both cohorts who did not have a prevalent cancer at baseline (except non-melanoma skin cancer) and had provided data on oral contraceptive use; incident liver cancer diagnoses were determined using linkage to National Health Service cancer registries. We compared risk in women who had ever used oral contraceptives with women who had never used oral contraceptives. Multivariable Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% CIs. For the systematic review and meta-analysis, we searched PubMed, Embase, CINAHL Plus, Web of Science, and Scopus from database inception to June 28, 2024, for existing observational studies. Study-specific log odds ratios (ORs) or log HRs were pooled and we determined the relative risk (RR) between oral contraceptive use and liver cancer across all studies using a fixed-effects model (PROSPERO number CRD42024552518). Findings A total of 2765 (0·21%) of 1 305 024 participants developed liver cancer in the MWS cohort (median follow-up 21·4 years; IQR 18·4–22·4) and 191 (0·08%) of 253 408 participants developed liver cancer in the UK Biobank (median follow-up 12·6 years; IQR 11·8–13·4). No association was observed between ever versus never use of oral contraceptives and liver cancer risk in either the MWS (HR 1·05, 95% CI 0·97–1·13; p=0·27) or the UK Biobank (1·08, 0·76–1·55; p=0·66). The meta-analysis of 23 observational studies, which included 5422 individuals with liver cancer, found no evidence of an association between ever versus never oral contraceptive use and liver cancer (RR 1·04, 0·98–1·11; I 2 45·9%, p=0·0080). In the meta-analysis of duration of oral contraceptive use, there was a slightly increased risk of liver cancer per 5 years of use of oral contraceptives (RR 1·06, 1·02–1·10; I 2 63·9%, p<0·0001), with corresponding subtype-specific RRs of 1·07 (1·00–1·14) for hepatocellular carcinoma and 1·06 (1·01–1·11) for intrahepatic cholangiocarcinoma (p heterogeneity =0·82). Interpretation The totality of observational studies suggests there is no association between ever versus never use of oral contraceptive and liver cancer risk. When looking at associations by duration of oral contraceptive use, there was little or no association with all liver cancer or its two main subtypes. There might be a small increased risk of liver cancer with longer duration of use, but residual confounding cannot be ruled out. Funding Canadian Institutes of Health Research, National Institutes of Health Intramural Program, and Cancer Research UK.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,012 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».