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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1986 Dec;40(4):289–294. doi: 10.1136/jech.40.4.289

Early oral contraceptive use and breast cancer: theoretical effects of latency.

K McPherson 1, P A Coope 1, M P Vessey 1
PMCID: PMC1052548  PMID: 3655620

Abstract

Many cancers and other chronic diseases are associated with a long delay between exposure to a putative risk factor and subsequent diagnosis. This presents well recognised problems in the elucidation of suspected risk factors by epidemiological methods. In this paper we discuss the interpretation in epidemiological studies of the effect of a possible risk factor when population exposure is recent and rapidly changing. An important contemporary example concerns the study of early oral contraceptive (OC) use in relation to the subsequent risk of breast cancer. Computer simulations reported here indicate that plausible delays in the manifestation of any effect on breast cancer incidence make it difficult to exclude early OC use as a risk factor for breast cancer, even when large well conducted epidemiological studies show no apparent increased risk. Methods for detecting a 'latent' effect are discussed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Armenian H. K., Lilienfeld A. M. Incubation period of disease. Epidemiol Rev. 1983;5:1–15. doi: 10.1093/oxfordjournals.epirev.a036254. [DOI] [PubMed] [Google Scholar]
  2. Buchanan J. B., Spratt J. S., Heuser L. S. Tumor growth, doubling times, and the inability of the radiologist to diagnose certain cancers. Radiol Clin North Am. 1983 Mar;21(1):115–126. [PubMed] [Google Scholar]
  3. DOLL R., HILL A. B. Smoking and carcinoma of the lung; preliminary report. Br Med J. 1950 Sep 30;2(4682):739–748. doi: 10.1136/bmj.2.4682.739. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Greenberg E. R., Barnes A. B., Resseguie L., Barrett J. A., Burnside S., Lanza L. L., Neff R. K., Stevens M., Young R. H., Colton T. Breast cancer in mothers given diethylstilbestrol in pregnancy. N Engl J Med. 1984 Nov 29;311(22):1393–1398. doi: 10.1056/NEJM198411293112201. [DOI] [PubMed] [Google Scholar]
  5. McPherson K., Neil A., Vessey M. P., Doll R. Oral contraceptives and breast cancer. Lancet. 1983 Dec 17;2(8364):1414–1415. doi: 10.1016/s0140-6736(83)90936-4. [DOI] [PubMed] [Google Scholar]
  6. Stadel B. V., Rubin G. L., Webster L. A., Schlesselman J. J., Wingo P. A. Oral contraceptives and breast cancer in young women. Lancet. 1985 Nov 2;2(8462):970–973. doi: 10.1016/s0140-6736(85)90524-0. [DOI] [PubMed] [Google Scholar]
  7. Tokunaga M., Norman J. E., Jr, Asano M., Tokuoka S., Ezaki H., Nishimori I., Tsuji Y. Malignant breast tumors among atomic bomb survivors, Hiroshima and Nagasaki, 1950-74. J Natl Cancer Inst. 1979 Jun;62(6):1347–1359. [PubMed] [Google Scholar]
  8. Vessey M. P., McPherson K., Yeates D., Doll R. Oral contraceptive use and abortion before first term pregnancy in relation to breast cancer risk. Br J Cancer. 1982 Mar;45(3):327–331. doi: 10.1038/bjc.1982.58. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Vessey M., Baron J., Doll R., McPherson K., Yeates D. Oral contraceptives and breast cancer: final report of an epidemiological study. Br J Cancer. 1983 Apr;47(4):455–462. doi: 10.1038/bjc.1983.74. [DOI] [PMC free article] [PubMed] [Google Scholar]

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