Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Онкологические риски и польза гормональной контрацепции: литературный обзор и практические вопросы
Онкологические риски и польза гормональной контрацепции: литературный обзор и практические вопросы
Ледина А.В., Короленкова Л.Н., Ледин Е.В. Онкологические риски и польза гормональной контрацепции: литературный обзор и практические вопросы. Гинекология. 2019; 21 (1): 75–79.
DOI: 10.26442/20795696.2019.1.190272
DOI: 10.26442/20795696.2019.1.190272
DOI: 10.26442/20795696.2019.1.190272
________________________________________________
DOI: 10.26442/20795696.2019.1.190272
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Цель. Представить современные данные о рисках онкологических заболеваний у женщин, использующих с целью предохранения от нежелательной беременности пероральные гормональные препараты, поскольку высокая онконастороженность является одной из наиболее существенных причин отказа от их приема.
Материалы и методы. Для написания данного обзора был осуществлен поиск источников в отечественных и зарубежных публикациях в российских и международных системах поиска (PubMed, eLibrary и пр.), которые были опубликованы в период с 2003 по 2019 г. В обзор были включены статьи из рецензируемой литературы и руководств для врачей и периодических изданий, идентифицируемых по ключевым словам: рак, онкологический риск, гормональная контрацепция, гормоны, неконтрацептивные эффекты комбинированных оральных контрацептивов (КОК).
Результаты. Гормональные контрацептивы обладают большим количеством положительных неконтрацептивных эффектов, в частности в отношении заболеваний, ассоциированных с менструальным циклом (предменструальный синдром и предменструальное дисфорическое расстройство, нарушения менструального цикла), бесплодия и ряда других заболеваний. Прием пероральных контрацептивов приводит к снижению заболеваемости раком яичников и колоректальным раком, но повышает онкологические риски, касающиеся шейки матки и молочной железы. На основании анализа данных литературы показано, что у женщин, которые когда-либо использовали гормональную контрацепцию, риск смерти от всех причин по сравнению с теми, кто никогда их не применял, более низкий.
Заключение. Для принятия решения об использовании КОК пациентки должны быть обследованы и компетентно проинформированы о преимуществах и рисках гормональной контрацепции.
Ключевые слова: гормональная контрацепция, комбинированные оральные контрацептивы, онкологические риски, рак, рак молочной железы, рак шейки матки, колоректальный рак.
Materials and methods. To write this review a search for domestic and foreign articles in Russian and international search systems (PubMed, eLibrary, etc.) which were published in the period from 2003 to 2019 was carried out. The review included articles from peer-reviewed literature and guidelines for physicians and periodicals identified by keywords: cancer, cancer risk, hormonal contraception, hormones, non-contraceptive effects of combined oral contraceptives (COCs).
Results. Hormonal contraceptives have a large number of beneficial non-contraceptive effects, particularly in relation to diseases associated with a menstrual cycle (premenstrual syndrome and premenstrual dysphoric disorder, menstrual disorders), infertility and a number of other diseases. Oral contraceptive use reduces an incidence of ovarian cancer and colorectal cancer but increases risks for cervix cancer and breast cancer. Based on the analysis of literature data, it was shown that women who have ever used hormonal contraception have a lower risk of death from all causes comparing to those who have never used them.
Conclusion. To make a decision on a use of COCs patients should be examined and competently informed about benefits and risks of hormonal contraception.
Key words: hormonal contraception, combined oral contraceptives, cancer risks, cancer, breast cancer, cervical cancer, colorectal cancer.
Материалы и методы. Для написания данного обзора был осуществлен поиск источников в отечественных и зарубежных публикациях в российских и международных системах поиска (PubMed, eLibrary и пр.), которые были опубликованы в период с 2003 по 2019 г. В обзор были включены статьи из рецензируемой литературы и руководств для врачей и периодических изданий, идентифицируемых по ключевым словам: рак, онкологический риск, гормональная контрацепция, гормоны, неконтрацептивные эффекты комбинированных оральных контрацептивов (КОК).
Результаты. Гормональные контрацептивы обладают большим количеством положительных неконтрацептивных эффектов, в частности в отношении заболеваний, ассоциированных с менструальным циклом (предменструальный синдром и предменструальное дисфорическое расстройство, нарушения менструального цикла), бесплодия и ряда других заболеваний. Прием пероральных контрацептивов приводит к снижению заболеваемости раком яичников и колоректальным раком, но повышает онкологические риски, касающиеся шейки матки и молочной железы. На основании анализа данных литературы показано, что у женщин, которые когда-либо использовали гормональную контрацепцию, риск смерти от всех причин по сравнению с теми, кто никогда их не применял, более низкий.
Заключение. Для принятия решения об использовании КОК пациентки должны быть обследованы и компетентно проинформированы о преимуществах и рисках гормональной контрацепции.
Ключевые слова: гормональная контрацепция, комбинированные оральные контрацептивы, онкологические риски, рак, рак молочной железы, рак шейки матки, колоректальный рак.
________________________________________________
Materials and methods. To write this review a search for domestic and foreign articles in Russian and international search systems (PubMed, eLibrary, etc.) which were published in the period from 2003 to 2019 was carried out. The review included articles from peer-reviewed literature and guidelines for physicians and periodicals identified by keywords: cancer, cancer risk, hormonal contraception, hormones, non-contraceptive effects of combined oral contraceptives (COCs).
Results. Hormonal contraceptives have a large number of beneficial non-contraceptive effects, particularly in relation to diseases associated with a menstrual cycle (premenstrual syndrome and premenstrual dysphoric disorder, menstrual disorders), infertility and a number of other diseases. Oral contraceptive use reduces an incidence of ovarian cancer and colorectal cancer but increases risks for cervix cancer and breast cancer. Based on the analysis of literature data, it was shown that women who have ever used hormonal contraception have a lower risk of death from all causes comparing to those who have never used them.
Conclusion. To make a decision on a use of COCs patients should be examined and competently informed about benefits and risks of hormonal contraception.
Key words: hormonal contraception, combined oral contraceptives, cancer risks, cancer, breast cancer, cervical cancer, colorectal cancer.
Полный текст
Список литературы
1. Подзолкова Н.М., Колода Ю.А., Роговская С.И. Современная контрацепция. Новые возможности и критерии безопасности: руководство для врачей. ГЭОТАР-Медиа, 2013.
[Podzolkova N.M., Koloda Iu.A., Rogovskaia S.I. Sovremennaia kontratseptsiia. Novye vozmozhnosti i kriterii bezopasnosti: rukovodstvo dlia vrachei. GEOTAR-Media, 2013 (in Russian).]
2. Руководство по контрацепции. Под ред. В.Н.Прилепской. М.: МЕД-пресс, 2006.
[Rukovodstvo po kontratseptsii. Pod red. V.N.Prilepskoi. Moscow: MED-press, 2006 (in Russian).]
3. Руководство Американской коллегии акушеров-гинекологов.
[Rukovodstvo Amerikanskoii kollegii akusherov-ginekologov (in Russian).]
4. Iversen L et al. Lifetime cancer risk and combined oral contraceptives: the Royal College of General Practitioners' Oral Contraception Study. Am J Obstet Gynecol 2017; 216: 580.e1–580.e9.
5. Gierisch JM et al. Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review. Cancer Epidemiol Biomarkers Prev 2013; 22 (11): 1931–43.
6. Endometrial cancer and oral contraceptives: an individual participant meta-analysis of 27 276 women with endometrial cancer from 36 epidemiological studies. Collaborative Group on Epidemiological Studies on Endometrial Cancer. Lancet Oncol 2015; 16: 1061-70.
7. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23.257 women with ovarian cancer and 87.303 controls. Collaborative Group on Epidemiological Studies of Ovarian Cancer. Lancet 2008; 26; 371 (9609): 303–14.
8. Breast cancer and Hormonal contraceptives: collaborative reanalysis of individual data on 53, 297 women with breast cancer and 100, 239 women without breast cancer from 54 epidemiological studies. Collaborative Group on Hormonal Factors in Breast Cancer. Lancet 1996; 347 (9017): 1713–27.
9. Mørch LS et al. Contemporary Hormonal Contraception and the Risk of Breast Cancer. N Engl J Med 2017; 377 (23): 2228–39.
10. Peachman RR. Weighing the Risks and Benefits of Hormonal Contraception. JAMA 2018; 319 (11): 1083–4.
11. White ND. Hormonal Contraception and Breast Cancer Risk. Am J Lifestyle Med 2018; 12 (3): 224–6.
12. Poosari A et al. Hormonal contraceptive use and breast cancer in Thai women. J Epidemiol 2014; 24: 216–20.
13. International Collaboration of Epidemiological Studies of Cervical Cancer, Appleby P et al. Cervical cancer and hormonal contraceptives: collaborative reanalysis of individual data for 16,573 women with cervical cancer and 35,509 women without cervical cancer from 24 epidemiological studies. Lancet 2007; 370: 1609–21.
14. Roupa E et al. The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort. PLoS One 2016; 11 (1): e0147029.
15. Moreno V et al. Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection: the IARC multicentric case-control study. Lancet 2002; 359: 1085–92.
16. La Vecchia C, Boccia S. Oral contraceptives, human papillomavirus and cervical cancer. Eur J Cancer Prev 2014; 23 (2): 110–2.
17. Smith JS et al. Cervical cancer and use of hormonal contraceptives: a systematic review. Lancet 2003; 361: 1159–67.
18. Vessey M, Yeates D. Oral contraceptive use and cancer: final from the O Oxford-Family Planning Association contraceptive study. Contraception 2013; 88: 678–83.
19. Рябинкина Т.С., Руднева О.Д. Сохраняет ли гормональная контрацепция здоровье женщин? Протективные свойства гормональной контрацепции. Информационный бюллетень. Под ред. В.Е.Радзинского. М.: StatusPraesens, 2014.
[Riabinkina T.S., Rudneva O.D. Sokhraniaet li gormonal'naia kontratseptsiia zdorov'e zhenshchin? Protektivnye svoistva gormonal'noi kontratseptsii. Informatsionnyi biulleten'. Pod red. V.E.Radzinskogo. Moscow: StatusPraesens, 2014 (in Russian).]
20. Hannaford PC et al. Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners’ Oral Contraception Study. BMJ 2010; 340: 927.
21. Combined Hormonal Contraception Faculty of Sexual & Reproductive Healthcare. FSRH Guideline. London, 2019.
22. World contraceptive patterns 2013. New York: United Nations, Department of Economic and Social Affairs (http://www.un.org/en/development/desa/population/publications/family/contraceptive-wallchart-2013.sh....
23. Barriga P et al. Hormonal contraception and risk of breast cancer: a critical look. Gynecol Endocrinol 2019: 1–3. DOI: 10.1080/09513590.2019.1576610
24. Butt SA et al. Hormonal contraceptive use and risk of pancreatic cancer-A cohort study among premenopausal women. PLoS One 2018; 13 (10): e0206358.
2. Rukovodstvo po kontratseptsii. Pod red. V.N.Prilepskoi. Moscow: MED-press, 2006 (in Russian).
3. Rukovodstvo Amerikanskoii kollegii akusherov-ginekologov (in Russian).
4. Iversen L et al. Lifetime cancer risk and combined oral contraceptives: the Royal College of General Practitioners' Oral Contraception Study. Am J Obstet Gynecol 2017; 216: 580.e1–580.e9.
5. Gierisch JM et al. Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review. Cancer Epidemiol Biomarkers Prev 2013; 22 (11): 1931–43.
6. Endometrial cancer and oral contraceptives: an individual participant meta-analysis of 27 276 women with endometrial cancer from 36 epidemiological studies. Collaborative Group on Epidemiological Studies on Endometrial Cancer. Lancet Oncol 2015; 16: 1061–70.
7. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23.257 women with ovarian cancer and 87.303 controls. Collaborative Group on Epidemiological Studies of Ovarian Cancer. Lancet 2008; 26; 371 (9609): 303–14.
8. Breast cancer and Hormonal contraceptives: collaborative reanalysis of individual data on 53, 297 women with breast cancer and 100, 239 women without breast cancer from 54 epidemiological studies. Collaborative Group on Hormonal Factors in Breast Cancer. Lancet 1996; 347 (9017): 1713–27.
9. Mørch LS et al. Contemporary Hormonal Contraception and the Risk of Breast Cancer. N Engl J Med 2017; 377 (23): 2228–39.
10. Peachman RR. Weighing the Risks and Benefits of Hormonal Contraception. JAMA 2018; 319 (11): 1083–4.
11. White ND. Hormonal Contraception and Breast Cancer Risk. Am J Lifestyle Med 2018; 12 (3): 224–6.
12. Poosari A et al. Hormonal contraceptive use and breast cancer in Thai women. J Epidemiol 2014; 24: 216–20.
13. International Collaboration of Epidemiological Studies of Cervical Cancer, Appleby P et al. Cervical cancer and hormonal contraceptives: collaborative reanalysis of individual data for 16,573 women with cervical cancer and 35,509 women without cervical cancer from 24 epidemiological studies. Lancet 2007; 370: 1609–21.
14. Roupa E et al. The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort. PLoS One 2016; 11 (1): e0147029.
15. Moreno V et al. Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection: the IARC multicentric case-control study. Lancet 2002; 359: 1085–92.
16. La Vecchia C, Boccia S. Oral contraceptives, human papillomavirus and cervical cancer. Eur J Cancer Prev 2014; 23 (2): 110–2.
17. Smith JS et al. Cervical cancer and use of hormonal contraceptives: a systematic review. Lancet 2003; 361: 1159–67.
18. Vessey M, Yeates D. Oral contraceptive use and cancer: final from the O Oxford-Family Planning Association contraceptive study. Contraception 2013; 88: 678–83.
19. Riabinkina T.S., Rudneva O.D. Sokhraniaet li gormonal'naia kontratseptsiia zdorov'e zhenshchin? Protektivnye svoistva gormonal'noi kontratseptsii. Informatsionnyi biulleten'. Pod red. V.E.Radzinskogo. Moscow: StatusPraesens, 2014 (in Russian).
20. Hannaford PC et al. Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners’ Oral Contraception Study. BMJ 2010; 340: 927.
21. Combined Hormonal Contraception Faculty of Sexual & Reproductive Healthcare. FSRH Guideline. London, 2019.
22. World contraceptive patterns 2013. New York: United Nations, Department of Economic and Social Affairs (http://www.un.org/en/development/desa/population/publications/family/contraceptive-wallchart-2013.sh....
23. Barriga P et al. Hormonal contraception and risk of breast cancer: a critical look. Gynecol Endocrinol 2019: 1–3. DOI: 10.1080/09513590.2019.1576610
24. Butt SA et al. Hormonal contraceptive use and risk of pancreatic cancer-A cohort study among premenopausal women. PLoS One 2018; 13 (10): e0206358.
[Podzolkova N.M., Koloda Iu.A., Rogovskaia S.I. Sovremennaia kontratseptsiia. Novye vozmozhnosti i kriterii bezopasnosti: rukovodstvo dlia vrachei. GEOTAR-Media, 2013 (in Russian).]
2. Руководство по контрацепции. Под ред. В.Н.Прилепской. М.: МЕД-пресс, 2006.
[Rukovodstvo po kontratseptsii. Pod red. V.N.Prilepskoi. Moscow: MED-press, 2006 (in Russian).]
3. Руководство Американской коллегии акушеров-гинекологов.
[Rukovodstvo Amerikanskoii kollegii akusherov-ginekologov (in Russian).]
4. Iversen L et al. Lifetime cancer risk and combined oral contraceptives: the Royal College of General Practitioners' Oral Contraception Study. Am J Obstet Gynecol 2017; 216: 580.e1–580.e9.
5. Gierisch JM et al. Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review. Cancer Epidemiol Biomarkers Prev 2013; 22 (11): 1931–43.
6. Endometrial cancer and oral contraceptives: an individual participant meta-analysis of 27 276 women with endometrial cancer from 36 epidemiological studies. Collaborative Group on Epidemiological Studies on Endometrial Cancer. Lancet Oncol 2015; 16: 1061-70.
7. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23.257 women with ovarian cancer and 87.303 controls. Collaborative Group on Epidemiological Studies of Ovarian Cancer. Lancet 2008; 26; 371 (9609): 303–14.
8. Breast cancer and Hormonal contraceptives: collaborative reanalysis of individual data on 53, 297 women with breast cancer and 100, 239 women without breast cancer from 54 epidemiological studies. Collaborative Group on Hormonal Factors in Breast Cancer. Lancet 1996; 347 (9017): 1713–27.
9. Mørch LS et al. Contemporary Hormonal Contraception and the Risk of Breast Cancer. N Engl J Med 2017; 377 (23): 2228–39.
10. Peachman RR. Weighing the Risks and Benefits of Hormonal Contraception. JAMA 2018; 319 (11): 1083–4.
11. White ND. Hormonal Contraception and Breast Cancer Risk. Am J Lifestyle Med 2018; 12 (3): 224–6.
12. Poosari A et al. Hormonal contraceptive use and breast cancer in Thai women. J Epidemiol 2014; 24: 216–20.
13. International Collaboration of Epidemiological Studies of Cervical Cancer, Appleby P et al. Cervical cancer and hormonal contraceptives: collaborative reanalysis of individual data for 16,573 women with cervical cancer and 35,509 women without cervical cancer from 24 epidemiological studies. Lancet 2007; 370: 1609–21.
14. Roupa E et al. The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort. PLoS One 2016; 11 (1): e0147029.
15. Moreno V et al. Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection: the IARC multicentric case-control study. Lancet 2002; 359: 1085–92.
16. La Vecchia C, Boccia S. Oral contraceptives, human papillomavirus and cervical cancer. Eur J Cancer Prev 2014; 23 (2): 110–2.
17. Smith JS et al. Cervical cancer and use of hormonal contraceptives: a systematic review. Lancet 2003; 361: 1159–67.
18. Vessey M, Yeates D. Oral contraceptive use and cancer: final from the O Oxford-Family Planning Association contraceptive study. Contraception 2013; 88: 678–83.
19. Рябинкина Т.С., Руднева О.Д. Сохраняет ли гормональная контрацепция здоровье женщин? Протективные свойства гормональной контрацепции. Информационный бюллетень. Под ред. В.Е.Радзинского. М.: StatusPraesens, 2014.
[Riabinkina T.S., Rudneva O.D. Sokhraniaet li gormonal'naia kontratseptsiia zdorov'e zhenshchin? Protektivnye svoistva gormonal'noi kontratseptsii. Informatsionnyi biulleten'. Pod red. V.E.Radzinskogo. Moscow: StatusPraesens, 2014 (in Russian).]
20. Hannaford PC et al. Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners’ Oral Contraception Study. BMJ 2010; 340: 927.
21. Combined Hormonal Contraception Faculty of Sexual & Reproductive Healthcare. FSRH Guideline. London, 2019.
22. World contraceptive patterns 2013. New York: United Nations, Department of Economic and Social Affairs (http://www.un.org/en/development/desa/population/publications/family/contraceptive-wallchart-2013.sh....
23. Barriga P et al. Hormonal contraception and risk of breast cancer: a critical look. Gynecol Endocrinol 2019: 1–3. DOI: 10.1080/09513590.2019.1576610
24. Butt SA et al. Hormonal contraceptive use and risk of pancreatic cancer-A cohort study among premenopausal women. PLoS One 2018; 13 (10): e0206358.
________________________________________________
2. Rukovodstvo po kontratseptsii. Pod red. V.N.Prilepskoi. Moscow: MED-press, 2006 (in Russian).
3. Rukovodstvo Amerikanskoii kollegii akusherov-ginekologov (in Russian).
4. Iversen L et al. Lifetime cancer risk and combined oral contraceptives: the Royal College of General Practitioners' Oral Contraception Study. Am J Obstet Gynecol 2017; 216: 580.e1–580.e9.
5. Gierisch JM et al. Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review. Cancer Epidemiol Biomarkers Prev 2013; 22 (11): 1931–43.
6. Endometrial cancer and oral contraceptives: an individual participant meta-analysis of 27 276 women with endometrial cancer from 36 epidemiological studies. Collaborative Group on Epidemiological Studies on Endometrial Cancer. Lancet Oncol 2015; 16: 1061–70.
7. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23.257 women with ovarian cancer and 87.303 controls. Collaborative Group on Epidemiological Studies of Ovarian Cancer. Lancet 2008; 26; 371 (9609): 303–14.
8. Breast cancer and Hormonal contraceptives: collaborative reanalysis of individual data on 53, 297 women with breast cancer and 100, 239 women without breast cancer from 54 epidemiological studies. Collaborative Group on Hormonal Factors in Breast Cancer. Lancet 1996; 347 (9017): 1713–27.
9. Mørch LS et al. Contemporary Hormonal Contraception and the Risk of Breast Cancer. N Engl J Med 2017; 377 (23): 2228–39.
10. Peachman RR. Weighing the Risks and Benefits of Hormonal Contraception. JAMA 2018; 319 (11): 1083–4.
11. White ND. Hormonal Contraception and Breast Cancer Risk. Am J Lifestyle Med 2018; 12 (3): 224–6.
12. Poosari A et al. Hormonal contraceptive use and breast cancer in Thai women. J Epidemiol 2014; 24: 216–20.
13. International Collaboration of Epidemiological Studies of Cervical Cancer, Appleby P et al. Cervical cancer and hormonal contraceptives: collaborative reanalysis of individual data for 16,573 women with cervical cancer and 35,509 women without cervical cancer from 24 epidemiological studies. Lancet 2007; 370: 1609–21.
14. Roupa E et al. The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort. PLoS One 2016; 11 (1): e0147029.
15. Moreno V et al. Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection: the IARC multicentric case-control study. Lancet 2002; 359: 1085–92.
16. La Vecchia C, Boccia S. Oral contraceptives, human papillomavirus and cervical cancer. Eur J Cancer Prev 2014; 23 (2): 110–2.
17. Smith JS et al. Cervical cancer and use of hormonal contraceptives: a systematic review. Lancet 2003; 361: 1159–67.
18. Vessey M, Yeates D. Oral contraceptive use and cancer: final from the O Oxford-Family Planning Association contraceptive study. Contraception 2013; 88: 678–83.
19. Riabinkina T.S., Rudneva O.D. Sokhraniaet li gormonal'naia kontratseptsiia zdorov'e zhenshchin? Protektivnye svoistva gormonal'noi kontratseptsii. Informatsionnyi biulleten'. Pod red. V.E.Radzinskogo. Moscow: StatusPraesens, 2014 (in Russian).
20. Hannaford PC et al. Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners’ Oral Contraception Study. BMJ 2010; 340: 927.
21. Combined Hormonal Contraception Faculty of Sexual & Reproductive Healthcare. FSRH Guideline. London, 2019.
22. World contraceptive patterns 2013. New York: United Nations, Department of Economic and Social Affairs (http://www.un.org/en/development/desa/population/publications/family/contraceptive-wallchart-2013.sh....
23. Barriga P et al. Hormonal contraception and risk of breast cancer: a critical look. Gynecol Endocrinol 2019: 1–3. DOI: 10.1080/09513590.2019.1576610
24. Butt SA et al. Hormonal contraceptive use and risk of pancreatic cancer-A cohort study among premenopausal women. PLoS One 2018; 13 (10): e0206358.
Авторы
А.В.Ледина*1,2, Л.И.Короленкова3, Е.В.Ледин4
1. Клинический госпиталь «Лапино». 143081, Московская обл., д. Лапино, 1-е Успенское ш., д. 111;
2. ФГАОУ ВО «Российский университет дружбы народов». 117198, Россия, Москва, ул. Миклухо-Маклая, д. 6;
3. ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н.Блохина» Минздрава России. 115478, Россия, Москва, Каширское ш., д. 23;
4. Клиническая больница №2 АО «Группа компаний "Медси"». 125284, Россия, Москва, 2-й Боткинский пр-д, д. 5, корп. 4
*antoninaledina@yandex.ru
1. Clinical Hospital "Lapino". 111, Lapino, 1-e Uspenskoe sh., Moscow reg., 143081, Russian Federation;
2. People’s Friendship University of Russia. 6, Miklukho-Maklaya st., Moscow, 117198, Russian Federation;
3. N.N.Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation.
23, Kashirskoe sh., Moscow, 115478, Russian Federation;
4. Clinical Hospital №2 "Medsi Group of Companies". 5, build. 4, 2-i Botkinskii pr-d, Moscow, 125284, Russian Federation
*antoninaledina@yandex.ru
1. Клинический госпиталь «Лапино». 143081, Московская обл., д. Лапино, 1-е Успенское ш., д. 111;
2. ФГАОУ ВО «Российский университет дружбы народов». 117198, Россия, Москва, ул. Миклухо-Маклая, д. 6;
3. ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н.Блохина» Минздрава России. 115478, Россия, Москва, Каширское ш., д. 23;
4. Клиническая больница №2 АО «Группа компаний "Медси"». 125284, Россия, Москва, 2-й Боткинский пр-д, д. 5, корп. 4
*antoninaledina@yandex.ru
________________________________________________
1. Clinical Hospital "Lapino". 111, Lapino, 1-e Uspenskoe sh., Moscow reg., 143081, Russian Federation;
2. People’s Friendship University of Russia. 6, Miklukho-Maklaya st., Moscow, 117198, Russian Federation;
3. N.N.Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation.
23, Kashirskoe sh., Moscow, 115478, Russian Federation;
4. Clinical Hospital №2 "Medsi Group of Companies". 5, build. 4, 2-i Botkinskii pr-d, Moscow, 125284, Russian Federation
*antoninaledina@yandex.ru
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.