INTRODUCTION
The Royal College of General Practitioners’ (RCGP)Oral Contraception Study is one of the world’s largestcontinuing investigations into the health effects of contraceptive pills.1 Early reports from the study indicated an increased risk of death among ever users of these contraceptives, mainly because of an excess of vascular
events among older users or those who smoked.23 A later report, based on up to 25 years of follow-up, suggested that most of the mortality effects of oral contraceptives
occurred in current or recent users, with few effects persisting beyond 10 years after stopping use.
However, the median age of women at follow-up was only 49 years and relatively few deaths from each type of cancer had occurred. Prolonged follow-up was needed to etermine how long any risks or benefits last after oral contraception is stopped. A recent publication from the study using incident cancer data has suggested that ever users of oral contraceptives may have a reduced overall risk of cancer. Whether this
translates into an important mortality benefit, and if so how it relates to other causes of death, is unknown.
We report the latest mortality findings from the RCGP Oral Contraception Study, based on up to 39 years of follow-up and nearly three times as many deaths as reported earlier.