Table 2.
Total and cause specific mortality in ever and never users of oral contraceptives among 121 577 participants in the Nurses’ Health Study, 1976-2012
| Cause of death | ICD-8 codes | Never users | Ever users | Hazard ratio (95% CI) | ||
|---|---|---|---|---|---|---|
| Model 1* | Model 2+disease category risk factors† | Model 3+mortality risk factors‡ | ||||
| All causes | 000 to 999, all E codes | 20 646 | 10 640 | 1.01 (0.98 to 1.03) | — | 1.02 (0.99 to 1.04) |
| All cancers: | 140 to 209 | 7420 | 4361 | 1.00 (0.96 to 1.04) | 1.01 (0.97 to 1.05) | 1.01 (0.97 to 1.05) |
| Large bowel and rectum | 153 to 154 | 693 | 361 | 0.95 (0.83 to 1.09) | 0.97 (0.84 to 1.11) | 0.97 (0.84 to 1.11) |
| Gallbladder/liver | 155 to 156 | 158 | 90 | 0.96 (0.73 to 1.28) | 0.98 (0.74 to 1.30) | 0.98 (0.74 to 1.30) |
| Lung | 162 | 1637 | 1007 | 1.05 (0.96 to 1.14) | 1.05 (0.96 to 1.14) | 1.05 (0.97 to 1.14) |
| Melanoma | 172 | 111 | 58 | 0.77 (0.55 to 1.09) | 0.76 (0.54 to 1.07) | 0.76 (0.54 to 1.08) |
| Breast | 174 | 1387 | 908 | 1.09 (0.99 to 1.20) | 1.09 (0.99 to 1.20) | 1.08 (0.98 to 1.18) |
| Cervical | 180 | 30 | 18 | 1.00 (0.52 to 1.92) | 1.01 (0.52 to 1.96) | 1.04 (0.54 to 2.02) |
| Uterine/endometrial | 182 | 224 | 111 | 0.79 (0.61 to 1.02) | 0.81 (0.63 to 1.04) | 0.81 (0.63 to 1.03) |
| Ovarian | 183 | 538 | 314 | 0.87 (0.75 to 1.02) | 0.88 (0.76 to 1.02) | 0.86 (0.74 to 1.00) |
| CNS-pituitary | 191, 194 | 214 | 141 | 1.03 (0.81 to 1.30) | 1.04 (0.82 to 1.31) | 1.05 (0.83 to 1.33) |
| Site unknown | 199 | 443 | 231 | 0.95 (0.80 to 1.12) | 0.95 (0.80 to 1.13) | 0.94 (0.79 to 1.12) |
| Other cancers | 140 to 209, except above | 1985 | 1122 | 1.01 (0.93 to 1.09) | 1.02 (0.94 to 1.11) | 1.03 (0.95 to 1.11) |
| All cardiovascular diseases: | 390 to 458 | 4257 | 1775 | 0.98 (0.92 to 1.04) | 1.00 (0.94 to 1.06) | 1.00 (0.94 to 1.06) |
| Ischemic heart disease | 410 to 414 | 1857 | 789 | 1.02 (0.94 to 1.12) | 1.04 (0.95 to 1.14) | 1.04 (0.95 to 1.14) |
| Other heart | 420 to 429 | 629 | 259 | 0.96 (0.81 to 1.12) | 0.97 (0.83 to 1.13) | 0.96 (0.82 to 1.12) |
| Cerebrovascular disease | 430 to 438 | 1196 | 445 | 0.89 (0.79 to 1.00) | 0.90 (0.80 to 1.01) | 0.90 (0.80 to 1.01) |
| Thromboembolic | 444 to 445, 451 to 453 | 104 | 52 | 1.05 (0.74 to 1.50) | 1.07 (0.75 to 1.52) | 1.06 (0.74 to 1.51) |
| Other circulatory | 390 to 409, 440 to 458, except above | 471 | 230 | 1.06 (0.90 to 1.26) | 1.08 (0.91 to 1.28) | 1.10 (0.93 to 1.31) |
| All digestive diseases: | 520 to 577 | 549 | 306 | 1.07 (0.92 to 1.24) | 1.07 (0.91 to 1.24) | 1.10 (0.95 to 1.28) |
| Liver disease | 570 to 573 | 226 | 153 | 1.14 (0.91 to 1.42) | 1.12 (0.90 to 1.41) | 1.15 (0.91 to 1.44) |
| Violence/accidents | 800 to 999, E808-999 | 640 | 444 | 1.20 (1.05 to 1.37) | 1.18 (1.03 to 1.35) | 1.20 (1.04 to 1.37) |
| Suicide | E950-959 | 111 | 130 | 1.43 (1.08 to 1.90) | 1.42 (1.07 to 1.88) | 1.41 (1.05 to 1.87) |
| Other diseases | All codes, except above | 6182 | 3030 | 1.03 (0.98 to 1.08) | — | 1.05 (1.00 to 1.10) |
| Unconfirmed | NA | 2916 | 1465 | 0.95 (0.89 to 1.02) | — | 0.98 (0.91 to 1.04) |
NA=not available.
*Adjusts for calendar time, age, body mass index, race, smoking status, and smoking amount/duration, with never users as reference.
†Adjusts for variables in model 1 and further adjusts for disease category risk factors. Cancers are adjusted for age at menarche, alcohol intake, physical activity, and family history of breast, colon, and ovarian cancer. Cardiovascular diseases are adjusted for alcohol intake, physical activity, and family history of heart disease. Digestive diseases are adjusted for alcohol intake. Violent/accidental deaths are adjusted for alcohol intake and marital status.
‡Adjusts for variables in model 2 and further adjusts for mortality risk factors, including body mass index at age 18, weight change since age 18, height, alcohol intake, physical activity, nut consumption, polyunsaturated fat, glycemic load, dietary cholesterol, cereal fiber, systolic blood pressure, use of antihypertensive drugs, personal history of diabetes, parental myocardial infarction before age 60, and time since menopause.