TY - JOUR
T1 - Long-term benefits and risks of alternative methods of fertility control in the United States
AU - Kawachi, Ichiro
AU - Colditz, Graham A.
AU - Hankinson, Sue
PY - 1994/7
Y1 - 1994/7
N2 - A risk-benefit analysis of five alternative approaches to fertility control among US women over the age of 30 was performed: tubal ligation, vasectomy, intrauterine device, barrier method (condom), and combined oral contraceptives. Taken into account were age-specific probabilities of contraceptive failure, fecundability, spontaneous abortion, reproductive mortality (ectopic pregnancy, delivery, or induced abortion), life table mortality, and mortality from specific cancer sites (ovarian, endometrial, breast, and prostate) and cardiovascular disease. Relative to women using no contraceptive precautions, the use of any method of contraception between the ages of 30 and 50 was associated with net benefit in terms of averted deaths. However, when duration of observation was extended up to age 80, we predicted an excess of about 880 deaths from prostate cancer per 100,000users of vasectomy. Other methods continued to be associated with net benefit, ranging from 130 to 360 deaths averted per 100,000 users. It was concluded that the non-reproductive risks and benefits of contraceptive methods continue to be relevant long after the reproductive years. The balance of risks and benefits may differ in other countries with different cause-specific and life table mortality rates.
AB - A risk-benefit analysis of five alternative approaches to fertility control among US women over the age of 30 was performed: tubal ligation, vasectomy, intrauterine device, barrier method (condom), and combined oral contraceptives. Taken into account were age-specific probabilities of contraceptive failure, fecundability, spontaneous abortion, reproductive mortality (ectopic pregnancy, delivery, or induced abortion), life table mortality, and mortality from specific cancer sites (ovarian, endometrial, breast, and prostate) and cardiovascular disease. Relative to women using no contraceptive precautions, the use of any method of contraception between the ages of 30 and 50 was associated with net benefit in terms of averted deaths. However, when duration of observation was extended up to age 80, we predicted an excess of about 880 deaths from prostate cancer per 100,000users of vasectomy. Other methods continued to be associated with net benefit, ranging from 130 to 360 deaths averted per 100,000 users. It was concluded that the non-reproductive risks and benefits of contraceptive methods continue to be relevant long after the reproductive years. The balance of risks and benefits may differ in other countries with different cause-specific and life table mortality rates.
KW - contraception
KW - mortality
KW - risk-benefit analysis
KW - tubal ligation
KW - vasectomy
UR - http://www.scopus.com/inward/record.url?scp=0028277818&partnerID=8YFLogxK
U2 - 10.1016/0010-7824(94)90076-0
DO - 10.1016/0010-7824(94)90076-0
M3 - Article
C2 - 7924318
AN - SCOPUS:0028277818
SN - 0010-7824
VL - 50
SP - 1
EP - 16
JO - Contraception
JF - Contraception
IS - 1
ER -