Relation of hormonal contraceptives use and risk of breast cancer incidence: a systematic review

سال انتشار: 1394
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 298

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شناسه ملی سند علمی:

ICBCMED11_261

تاریخ نمایه سازی: 21 اردیبهشت 1397

چکیده مقاله:

Introduction: Hormonal contraceptive use has been effective to prevent unwanted pregnancies and its usage trend is increasing all over the world. Nevertheless, these contraception methods like other contraceptives have side-effects on women’s health. The present study aimed to determine the relation of hormonal contraceptive use and risk of women’s breast cancer incidence. Methods: Initial searching was conducted using related keywords such as breast cancer , breast malignancy , breast neoplasm , hormonal contraceptives , injectable hormonal contraceptives and oral contraceptives with Boolean operators, in MEDLINE ، EMBASE ، Cochrane Database of Systematic Reviews data bases for published articles from 2000 to 2015. Inclusion criteria included English language full-text publications, all controlled studies including case-control, cohort, clinical trials and patient-level meta-analyses. Exclusion criteria were: cross-sectional study, reviews, case report/series, editorial and letter to editor, study that did not examine breast cancer/malignancy as outcome variable and study that was conducted in specific population such as family history of breast cancer. At first, searching was done for titles and abstracts of articles by two researchers separately. Then, each full-text related article was precisely based on the appraisal checklist in accordance with the type of study. Finally, searching process and obtained articles were peerreviewed and supervised by third researcher. Results: Firstly 168 studies were obtained, of these, 113 studies were eliminated due to the irrelevancy of the outcome variable, type of study, full-text writing language. From 55 remained studies, 12 of them were excluded because full-text study was not available (4), oral hormonal contraceptives were not used for contraception objectives (5) and duration of hormonal agents were not mentioned clearly (3). Finally, 43 studies remained with case-control design(23), cohort(9), clinical trial(9) and meta-analyses(2). Discussion and conclusions: Except for one, all studies manifested that using mixed hormonal contraceptives (estrogens/ progestogens) for at least 5 years or more increase slightly but statistically significant (around 2 folds) risk of breast cancer incidence. Relation of injectable progestogen only agents ( depomedroxy progesterone) and/ or levonorgestrel-releasing intrauterine system( Mirena) and breast cancer were studied only in 6 studies that none of them proved such a causative relation. Therefore, it is highly recommended risk monitoring for malignant breast tumors should be accomplished by health care providers in mixed contraceptives current users and long term users.

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نویسندگان

Sepideh Hajian

assistant professor, Department of midwifery & reproductive health, Shahid Beheshti University of Medical Science, Tehran.

Parastoo Hajian

Radiation oncologist, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Science, Tehran

Zohreh Keshavar

assistant professor, Department of midwifery & reproductive health, Shahid Beheshti University of Medical Science, Tehran.