INTRODUCTION
The Royal College of General Practitioners’ (RCGP)
Oral Contraception Study is one of the world’s largest
continuing 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.4
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 determine 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.5 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.