ArticleBMJ (Clinical research ed.)2014
Oral contraceptive use and mortality after 36 years of follow-up in the Nurses' Health Study: prospective cohort study.
Article in BMJ (Clinical research ed.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 6 syntheses or guidelines pooled it, 116 citations in OpenAlex.
- Assessing the impact of contraceptive use on reproductive cancer risk among women of reproductive age-a systematic review.Frontiers in global women's health · 2024Pooled it
- Renin-Angiotensin-Aldosterone System in Women Using Combined Oral Contraceptive: A Systematic Review.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2022Pooled it
- Hormonal Contraceptive Use and Risk of Attempted and Completed Suicide: a Systematic Review and Narrative Synthesis.The Psychiatric quarterly · 2020Pooled it
- The impact of hormones and reproductive factors on the risk of bladder cancer in women: results from the Nurses' Health Study and Nurses' Health Study II.International journal of epidemiology · 2020Pooled it
- Hierarchies of evidence applied to lifestyle Medicine (HEALM): introduction of a strength-of-evidence approach based on a methodological systematic review.BMC medical research methodology · 2019Pooled it
- Epigenome-wide association study for lifetime estrogen exposure identifies an epigenetic signature associated with breast cancer risk.Clinical epigenetics · 2019Pooled it
- Trial
- Associations of oral contraceptives with expression of CD44, CD24, and ALDH1A1 stem cell markers in women with benign breast biopsies.Breast cancer research : BCR · 2026Article
- 'Not Angels but Humans' An Exploratory Qualitative Study of Female Nurses With Lived Experience of Self-Harm and Suicidal Behaviours.Journal of advanced nursing · 2026Article
- Hormonal contraception and the risk of suicidal behaviour: a Swedish nationwide register-based study.BMJ open · 2025Article
- Hormonal contraceptive use and anaemia: a nation-wide pharmacoepidemiological study from Northern Europe.European journal of epidemiology · 2025Article
- Prospective cohort of pre-diagnosis hormone exposure and post-diagnosis sex hormone levels with survival outcomes: Alberta Endometrial Cancer Cohort Study.Endocrine oncology (Bristol, England) · 2025Article
- Review
- Disparities in the prevalence of suicidal ideation according to oral contraceptive pill use among US women: A cross-sectional study.Health science reports · 2024Article
- Associations of Oral Contraceptive Use With Cardiovascular Disease and All-Cause Death: Evidence From the UK Biobank Cohort Study.Journal of the American Heart Association · 2023Article
- Examining the relation between oral contraceptive use and attentional engagement in everyday life.Frontiers in human neuroscience · 2023Article
- Women's health, hormonal balance, and personal autonomy.Frontiers in medicine · 2023Review
- Association of Proton Pump Inhibitor Use With All-Cause and Cause-Specific Mortality.Gastroenterology · 2022Article
- Review
- Associations of Oral Contraceptives with Mammographic Breast Density in Premenopausal Women.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo determine whether use of oral contraceptives is associated with all cause and cause specific mortality.
designProspective cohort study.
settingNurses' Health Study, data collected between 1976 and 2012. POPULATION: 121,701 participants were prospectively followed for 36 years; lifetime oral contraceptive use was recorded biennially from 1976 to 1982.
main outcome measuresOverall and cause specific mortality, assessed throughout follow-up until 2012. Cox proportional hazards models were used to calculate the relative risks of all cause and cause specific mortality associated with use of oral contraceptives.
resultsIn our population of 121,577 women with information on oral contraceptive use, 63,626 were never users (52%) and 57,951 were ever users (48%). After 3.6 million person years, we recorded 31,286 deaths. No association was observed between ever use of oral contraceptives and all cause mortality. However, violent or accidental deaths were more common among ever users (hazard ratio 1.20, 95% confidence interval 1.04 to 1.37). Longer duration of use was more strongly associated with certain causes of death, including premature mortality due to breast cancer (test for trend P<0.0001) and decreased mortality rates of ovarian cancer (P=0.002). Longer time since last use was also associated with certain outcomes, including a positive association with violent or accidental deaths (P=0.005).
conclusionsAll cause mortality did not differ significantly between women who had ever used oral contraceptives and never users. Oral contraceptive use was associated with certain causes of death, including increased rates of violent or accidental death and deaths due to breast cancer, whereas deaths due to ovarian cancer were less common among women who used oral contraceptives. These results pertain to earlier oral contraceptive formulations with higher hormone doses rather than the now more commonly used third and fourth generation formulations with lower estrogen doses.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.