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Biomedical subjects

D Yeates

Publications and source records attributed to D Yeates.

At least 55 records · Page 3Linked to original sources
PubMed1985

Body size and survival in premenopausal breast cancer.

The survival experience of 582 women with premenopausal breast cancer was examined to determine whether prognosis was related to body size or to demographic and reproductive factors. During the follow-up period 228 patients died and 18 emigrated or were lost to follow-up. Usual body weight, reported at the time of diagnosis, was a strong predictor of survival, with a statistically significant trend towards lower survival with increasing weight. Height and obesity (Quetelet index) were not significantly related to survival, although the tallest women and the most obese women appeared to fare worst. Other characteristics of prognostic importance were disease stage and reproductive history (women who were older when their first child was born fared better). Women aged 46-50 when diagnosed also appeared more likely to survive but no clear trend with age was evident. Other characteristics of the women including social class, cigarette use and oral contraceptive use were not significantly related to survival probability.

Adult↗
PubMed1985

Oral contraception and serious psychiatric illness: absence of an association.

The incidence of serious psychiatric illness, as measured by first referral to hospital for specialist advice and treatment, has been investigated among 16,746 women taking part in the Oxford Family Planning Association contraceptive study. Of these women, 9,504 were recruited while using oral contraceptives, 4,144 while using a diaphragm and 3,098 while using an intrauterine device. The results are reassuring with respect to oral contraceptive use. First referral rates per 1000 woman-years of observation in the oral contraceptive, diaphragm, and intrauterine device entry groups were 3.0, 2.6, and 2.8 respectively for non-psychotic psychiatric disorders and 0.46, 0.43 and 0.53 respectively for psychotic disorders. Attempted suicide occurred only 40% as often amongst diaphragm users as amongst users of oral contraceptives or intrauterine devices; this finding presumably reflects the characteristics of women who choose the diaphragm as their birth control method.

Adult↗
PubMed1984

Maternal age and breast cancer risk.

Maternal age at time of birth was investigated as a risk factor for breast cancer in a study of 1,176 matched case-control pairs. There was no pattern of increasing adjusted relative risk of breast cancer with increasing maternal age, nor was the mean maternal age of cases older than that of controls. Similar negative results were found among the subset of subjects up to 35 years old, a group previously found to show marked maternal age effects. Thus previous reports of an association between breast cancer and advanced maternal age may have been due to chance, extraneous factors, or a misleading reliance on unadjusted mean maternal ages, rather than on relative risks.

Adult↗
PubMed1983

Neoplasia of the cervix uteri and contraception: a possible adverse effect of the pill.

The incidence of biopsy-proven cervical neoplasia during a 10-year follow-up was determined in 6838 parous women who entered the Oxford-Family Planning Association contraceptive study while using oral contraceptives and 3154 parous women who entered the study while using an intrauterine device (IUD). Risk factors for cervical neoplasia, continuation of attendance at family planning clinics, and frequency of examination by cervical cytology were similar in the two groups. All 13 cases of invasive cancer occurred in women in the oral contraceptive group; 9 had more than 6 years' use of the pill. Both carcinoma-in-situ and dysplasia also occurred more frequently in the oral contraceptive group than in the IUD group, and when the two conditions were considered together there was a trend in incidence with duration of oral contraceptive use. The incidence for all three forms of neoplasia combined rose from 0.9 per 1000 woman-years in those with up to 2 years' pill use to 2.2 per 1000 woman-years in those with more than 8 years' pill use. Amongst IUD users, there was no such trend in incidence with duration of use: the rate fluctuated around 1.0 per 1000 woman-years. The great majority of cases of invasive cancer were detected by means of cervical smears and were treated while the disease was still curable. Long-term users of oral contraceptives should have regular cervical cytological examination.

Adult↗
PubMed1983

Oral contraceptives and breast cancer: final report of an epidemiological study.

During 1968-1980, 1176 women aged 16-50 years with newly diagnosed breast cancer and a like number of matched controls were interviewed at 9 teaching hospitals in London and Oxford and asked about their use of oral contraceptives. The results were reassuring. A few statistically significant differences in oral contraceptive use were found between the breast cancer and control groups, but the data were subdivided in many ways so that some "significant" differences would have been expected through the play of chance alone. Certainly no patterns of risk emerged which would suggest that any of the associations were causal. It must be stressed, however, that the data are still sparse in some important subcategories--for example, only small numbers of both cases and controls had prolonged oral contraceptive use before their first term pregnancy. For this reason, it is important that information on the possible relationship between pill use and breast cancer should continue to be collected. Women who had never used oral contraceptives presented with appreciably more advanced tumours than those who had been using oral contraceptives during the year before detection of cancer, while past users were in an intermediate position. These differences in staging were reflected in the pattern of survival. Possible explanations for these observations include "surveillance bias" among oral contraceptive users leading to earlier diagnosis and a beneficial biological effect of oral contraceptives on tumour growth and spread. Women with breast cancer reported never having used any method of contraception and heavy cigarette smoking (greater than or equal to 15 per day) significantly less often than controls. We could find no obvious explanation for the former observation, but suspect that the latter reflects the unrepresentative smoking habits of our hospital controls rather than a protective effect of smoking against breast cancer.

Adolescent↗
PubMed1983

Tubal sterilization: findings in a large prospective study.

Of the 17032 women taking part in a large prospective study of the beneficial and harmful effects of different contraceptive methods, 2243 (13%) had undergone tubal sterilization by the end of 1981 while another 3551 (21%) had husbands who had undergone vasectomy. The most commonly used female sterilization procedure was laparoscopic tubal diathermy. About 19% of all operations were carried out at the time of a delivery or during the subsequent 4 weeks. In total, 16 accidental pregnancies have occurred in the sterilized women, the failure rate during the 12 months after surgery being 0.37 per 100 woman-years and the rate during the subsequent months being 0.10 per 100 woman-years. Of the 16 accidental pregnancies, seven were ectopic. In an analysis comparing women who had undergone tubal sterilization with those whose husbands had undergone vasectomy, there was little evidence of any excess occurrence of gynaecological or psychiatric disorders in the former group.

Adult↗
PubMed1982

Vaginal spermicides and outcome of pregnancy: findings in a large cohort study.

By the end of 1980, 5729 singleton planned pregnancies, 1552 singleton unplanned pregnancies, and 81 multiple pregnancies had been observed among the 17032 participants in the Oxford-Family Planning Association contraceptive study. The outcome of these pregnancies was investigated in relation to the use of vaginal spermicides. There was some suggestion that spermicide use might have a small adverse effect on the risk of congenital malformations, especially among infants conceived as a result of contraceptive failure. There was not, however, any evidence of any other adverse effect of spermicide use. In particular, the results provide strong evidence against the hypothesis that spermicide use has any appreciable effect on the risk of spontaneous abortion.

Abnormalities, Drug-Induced↗
PubMed1982

Oral contraceptive use and abortion before first term pregnancy in relation to breast cancer risk.

A recent publication from California in this journal has suggested that both prolonged oral contraceptive use and abortion before first term pregnancy increases the risk of breast cancer in young women. Data are presented on 1176 women aged 16-50 years with breast cancer, interviewed in London or in Oxford, together with a like number of matches control subjects. The results are entirely reassuring, being, in fact, more compatible with protective effects than the reverse. Possible reasons for the differences between the 2 sets of data are discussed.

Abortion, Spontaneous↗
PubMed1981

Pelvic inflammatory disease and the intrauterine device: findings in a large cohort study.

The incidence of pelvic inflammatory disease was investigated among parous women taking part in the Oxford-Family Planning Association contraceptive study. Hospital admission rates for "acute definite" disease were 1.51 per 1000 woman-years among those currently using an intrauterine device (IUD) and 0.14 per 1000 woman-years among those using other methods of birth control (age-standardised relative risk 10.5 to 1 with 95% confidence limits of 5.4 to 1 and 32 to 1). There was little evidence of an increased risk of such disease in ex-users of an IUD. Hospital admission for "chronic definite" disease, on the other hand, was commoner in ex-users of an IUD than in current users. Acute definite disease occurred somewhat more frequently during the early months of use of an IUD than during the later months. While the rate of such disease was increased in users of each type of device, the highest rate (8.1 per 1000 woman-years) was observed in users of the Dalkon shield. This rate, however, was based on only three affected women.

Acute Disease↗
PubMed1981

Risk factors for benign breast disease.

The importance of various risk factors for benign breast disorders has been assessed an analysis of data obtained from a multicenter cohort study of contraceptive use among women in the United Kingdom (the Oxford Family Planning Association Contraceptive Study). Cases comprised all women diagnosed as having any type of benign breast lesion; 74 had fibroadenoma, 211 had histologically confirmed chronic cystic disease, 331 had breast lumps not subjected to biopsy and 70 had other disease. Each case was individually matched with another study participant who was free from recognized breast disease. Matching factors were center of recruitment, date of recruitment, age at entry, and continuation in the study. An inverse association was found between use of oral contraceptives and the risk of the first three conditions. Current users of the pill had the lowest risk, particularly when the use was for an extended period. In contrast, past users demonstrated no reduction in risk. The reduction in risk for chronic cystic disease appeared to relate to the amount of progestogen contained in the pill. No significant association was observed between the risk of any of the conditions and either parity or age at first livebirth. Women of low social class and obese women were at low risk, perhaps reflecting diagnostic biases.

Adult↗
PubMed1979

Risk of ectopic pregnancy and duration of use of an intrauterine device.

A number of investigations have shown that accidental pregnancies occurring in long-term users of an intrauterine device (IUD) are more likely to be ectopic than those occurring in short-term users. An analysis of data collected in the Oxford-Family Planning Association contraceptive study, strongly suggests that the earlier findings are attributable to the progressive reduction in the frequency of intrauterine implantation with duration of IUD use. The absolute risk of ectopic pregnancy in IUD users was found to remain fairly constant with duration of use at about 1.2 per 1000 women per annum.

Abortion, Spontaneous↗