{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:02:39Z","timestamp":1791921759818,"version":"4.3.4"},"reference-count":21,"publisher":"BMJ","issue":"6714","license":[{"start":{"date-parts":[[1989,12,16]],"date-time":"1989-12-16T00:00:00Z","timestamp":629769600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1989,12,16]]},"abstract":"<jats:p>OBJECTIVE--To see whether the use of oral contraceptives influences mortality. DESIGN--Non-randomised cohort study of 17,032 women followed up on an annual basis for an average of nearly 16 years. SETTING--17 Family planning clinics in England and Scotland. SUBJECTS--Women recruited during 1968-74. At the time of recruitment each woman was aged 25-39, married, a white British subject, willing to participate, and either a current user of oral contraceptives or a current user of a diaphragm or intrauterine device (without previous exposure to the pill). MAIN OUTCOME MEASURES--Overall mortality and cause specific mortality. RESULTS--238 Deaths occurred during the follow up period. The main analyses concerned women entering the study while using either oral contraceptives or a diaphragm or intrauterine device. The overall relative risk of death in the oral contraceptive users was 0.9 (95% confidence interval 0.7 to 1.2). Though the numbers of deaths were small in most individual disease categories, the trends observed were generally consistent with findings in other reports. Thus the relative risk of death in the oral contraceptive users was 4.9 (95% confidence interval 0.7 to 230) for cancer of the cervix, 3.3 (95% confidence interval 0.9 to 17.9) for ischaemic heart disease, and 0.4 (95% confidence interval 0.1 to 1.2) for ovarian cancer. There was a linear trend in the death rates from cervical cancer and ovarian cancer (in opposite directions) with total duration of oral contraceptive use. Death rates from breast cancer (relative risk 0.9; 95% confidence interval 0.5 to 1.4) and suicide and probable suicide (relative risk 1.1; 95% confidence interval 0.3 to 3.6) were much the same in the two contraceptive groups. In 1981 the relative risk of death in oral contraceptive users from circulatory diseases as a group was reported to be 4.2 (95% confidence interval 2.3 to 7.7) in the Royal College of General Practitioners oral contraception study. The corresponding relative risk in this study was only 1.5 (95% confidence interval 0.7 to 3.0). CONCLUSIONS--These findings contain no significant evidence of any overall effect of oral contraceptive use on mortality. None the less, only small numbers of deaths occurred during the study period and a significant adverse (or beneficial) overall effect might emerge in the future. Interestingly, the mortality from circulatory disease associated with oral contraceptive use was substantially less than that found in the Royal College of General Practitioners study.<\/jats:p>","DOI":"10.1136\/bmj.299.6714.1487","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T15:19:55Z","timestamp":1238685595000},"page":"1487-1491","source":"Crossref","is-referenced-by-count":102,"title":["Mortality among oral contraceptive users: 20 year follow up of women in a cohort study."],"prefix":"10.1136","volume":"299","author":[{"given":"M. P.","family":"Vessey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Villard-Mackintosh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"McPherson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Yeates","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1989,12,16]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"General Practitioniers Oral Contraception Study (iroup. Further analyses of'mortality in oral contraceptive users","volume":"54","author":"of, Royal College","year":"1981","unstructured":"Royal College of General Practitioniers Oral Contraception Study (iroup. Further analyses of'mortality in oral contraceptive users. Lancet 1981;i: 54 1-6.","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1001\/jama.1979.03300070040020","article-title":"Epidemiology of hepatocellular adcnoma. 'I'he role of oral contraceptive use","volume":"242","author":"Rooks, J.B.; Dry, H.W.; Ishak, K.G.","year":"1979","unstructured":"Rooks JB, Dry HW, Ishak KG, et al. Epidemiology of hepatocellular adcnoma. 'I'he role of oral contraceptive use. JAMA 1979;242:644-8.","journal-title":"JAMA"},{"issue":"292","key":"ref_3","first-page":"1357","article-title":"Cancer of the liver and the use of' oral contraceptives","volume":"1986","author":"Forman 1), V'incent TJ, Doll R","unstructured":"Forman 1), V'incent TJ, Doll R. Cancer of the liver and the use of' oral contraceptives. Br.Iled7 1986;292: 1357-61.","journal-title":"Br. Iled7"},{"key":"ref_4","first-page":"1","article-title":"Vessev MP'. Female hormones and vascular disease-an epidcmiological overview. BritiihJ7ournal ofFamilyP 'lanning","volume":"6","year":"1980","unstructured":"Vessev MP'. Female hormones and vascular disease-an epidcmiological overview. BritiihJ7ournal ofFamilyP 'lanning 1980;6(suppl) 1-12."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/0753-3322(89)90208-4","article-title":"Carcinoma of' the cervix and oral contraceptisesepidemiological studies","volume":"43","author":"Vessev, M, (irice D","year":"1989","unstructured":"Vessev M, (irice D. Carcinoma of' the cervix and oral contraceptisesepidemiological studies. Biomed Pharmacother 1989;43: 157-60.","journal-title":"Biomed Pharmacother"},{"key":"ref_6","first-page":"23","article-title":"Oral contraceptives in relation to cancer of' the breast and reproductise tract -an epidemiological overview","volume":"15","author":"Schlesselman, J.J.","year":"1989","unstructured":"Schlesselman JJ. Oral contraceptives in relation to cancer of' the breast and reproductise tract -an epidemiological overview. British Journial oi'i'amily Plannitng 1989;15:23-33.","journal-title":"British Journial oi'i'amily Plannitng"},{"key":"ref_7","first-page":"68","article-title":"Oral contraceptive use anid malignant melanoma in Australia","volume":"50","author":"Beral, V.; Evans, S.; Shaw, H.; Gi, Milton","year":"1984","unstructured":"Beral V, Evans S, Shaw H, Milton Gi. Oral contraceptive use anid malignant melanoma in Australia. Brj7 (Catcer 1984;50:68 1-5."},{"key":"ref_8","first-page":"759","article-title":"I'hc Roval College of(iciGeral liractitioners oral contraceptioni study: some recent obscrvations","volume":"11","author":"Kay, C.R.","year":"1984","unstructured":"Kay CR. I'hc Roval College of(iciGeral liractitioners oral contraceptioni study: some recent obscrvations. Clin Ohsteii Gvnecol 1984;11:759-86.","journal-title":"Clin Ohsteii Gvnecol"},{"key":"ref_9","first-page":"650","article-title":"Steroid Hormone StUdy (iGroup. I'he reduction in risk o' ovarian cancer associated with oral contraceptive usc. \\'","volume":"316","author":"and, Cancer","year":"1987","unstructured":"Cancer and Steroid Hormone StUdy (iGroup. I'he reduction in risk o' ovarian cancer associated with oral contraceptive usc. \\' InglI Aled 1987;316:650-5.","journal-title":"InglI Aled"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1038\/bjc.1989.124","article-title":"Oral contraceptives and breast cancer: latest findings in a large cohort study","volume":"59","author":"Vessev, M.P.; McPherson, K.; Villard-Mackintosh, L.; Yeates, D.","year":"1989","unstructured":"Vessev MP, McPherson K, Villard-Mackintosh L, Yeates D. Oral contraceptives and breast cancer: latest findings in a large cohort study. Br] Cancer 1989;59:613-7.","journal-title":"Br] Cancer"},{"key":"ref_11","first-page":"930","article-title":"Yeates 1). Neoplasia of the cervix uteri and contraception: a fpssible adverse effect of the pill","volume":"ii:","author":"Vesscy, M.P.; Lawless, M.; McPherson, K.","year":"1983","unstructured":"Vesscy MP, Lawless M, McPherson K, Yeates 1). Neoplasia of the cervix uteri and contraception: a fpssible adverse effect of the pill. Lancet 1983;ii:930-4.","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1136\/bmj.294.6586.1518","article-title":"Yeates 1). Ovarian neoplasms, functional ovarian cysts, and oral contraceptives","volume":"294","author":"Vessev, M.; Metcalfe, A.; Wells, C.; McPherson, K.; Westhoff, C.","year":"1987","unstructured":"Vessev M, Metcalfe A, Wells C, McPherson K, Westhoff C, Yeates 1). Ovarian neoplasms, functional ovarian cysts, and oral contraceptives. 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BrMedej 1989;298:165-8.","journal-title":"BrMedej"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1056\/NEJM198108203050802","article-title":"Risk of mvocardial infarction in relation to current and discontinued use of oral contraceptives","volume":"305","author":"Slone, D.; Shapiro, S.; l)W, Kaufman; Rosenberg, L.; Miettinen, O.S.; Stolley, P.D.","year":"1981","unstructured":"Slone D, Shapiro S, Kaufman l)W, Rosenberg L, Miettinen OS, Stolley PD. Risk of mvocardial infarction in relation to current and discontinued use of oral contraceptives. 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