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Biomedical subjects

C R Kay

Publications and source records attributed to C R Kay.

At least 37 records · Page 2Linked to original sources
PubMed1989

Oral contraception, smoking and inflammatory bowel disease--findings in the Royal College of General Practitioners Oral Contraception Study.

Data from the Royal College of General Practitioners Oral Contraception Study have been examined to determine whether oral contraceptive use was associated with the development of Crohn's disease or ulcerative colitis. Over a 17 year period Crohn's disease developed in 42 women and ulcerative colitis in 78. The incidence of both diseases was greater in oral contraceptive users compared to non-users with the rate ratio for Crohn's disease being 1.7 (95% confidence limits, 0.88, 3.2) and for ulcerative colitis being 1.3 (95% confidence limits 0.82, 2.0). For both diseases incidence was unrelated to parity or social class, but women smoking at recruitment had a greater incidence of Crohn's disease (rate ratio 1.8, 95% confidence limits 0.93, 3.3) and a reduced incidence of ulcerative colitis (rate ratio 0.68, 95% confidence limits 0.41, 1.1). Although these results are based on small numbers and could be chance findings, they are consistent with other studies showing associations between oral contraceptive use, smoking and the development of Crohn's disease and ulcerative colitis.

Adolescent↗
PubMed1988

Breast cancer and the pill--a further report from the Royal College of General Practitioners' oral contraception study.

An analysis of the occurrence of breast cancer in this long-term prospective cohort study shows a significant relative risk (RR) in women who have ever used oral contraceptives (OC) of 3.33 in women age 30 to 34 years at diagnosis and an RR of 5.88 (P = 0.0011) in women who were parity 1 at the time of diagnosis. In women below the age of 35 years the RR of 2.38 was not significant. There was no increased risk in women over the age of 35 years. A significant trend relating to duration of use was demonstrable in women who were parity 1 in the analysis of both current and ever-users. An analysis by time since stopping OC use revealed a significant trend in all ever-users, but the trends were much steeper in women of parity 1 or aged 30 to 34 years at diagnosis. There was no evidence that the increased rates in OC users were related to the oestrogen or progestogen dose. The 5 year survival rate in users diagnosed under the age of 35 years was significantly poorer than in comparable non-users. It is possible that the increased rates in younger OC users might be due to an accelerated presentation of breast cancer in those women who would otherwise have been diagnosed at a later time. The non-significant excess risk in users under 35 years of age was approximately 1 in 7,000 users per year. The unresolved discrepancies between the results of the published studies make it impossible at the present time to decide whether or not OC use is associated with an increased risk of breast cancer.

Adult↗
PubMed1987

Pregnancy following induced abortion: maternal morbidity, congenital abnormalities and neonatal death. Royal College of General Practitioners/Royal College of Obstetricians and Gynaecologists Joint Study.

In a prospective cohort study of the long-term sequelae of induced abortion, a comparison is made between a group of 6418 women who had an induced abortion (cases) and a control group of 8059 women recruited with an unplanned pregnancy which was not terminated with an induced abortion (controls). The present paper reports on 729 cases and 1754 controls who had a post-recruitment pregnancy. In general, prior induced abortion had no material effect on the rate of pregnancy-related morbidity, nor on the rate of congenital abnormalities and neonatal death in the offspring. There was, however, a significant difference in two specific conditions. In the post-index pregnancy in the cases there was an increased relative risk (RR 2.26) of the occurrence of urinary tract infection and a decreased risk (RR 0.25) of pregnancy-related anaemia.

Abortion, Induced↗
PubMed1985

Outcome of pregnancy following induced abortion. Report from the joint study of the Royal College of General Practitioners and the Royal College of Obstetricians and Gynaecologists.

A total of 1590 general practitioners and 795 gynaecologists in England, Scotland and Wales are participating in a long-term, prospective study concerning the sequelae of induced abortion. In the present report a comparison is made between the outcome of the first post-index pregnancy in 745 women whose index pregnancy ended in an induced abortion (cases) and that in 1339 women who had an unplanned index pregnancy but were not referred for induced abortion (controls). There were no statistically significant differences between cases and controls. The increased relative risk which was found amongst the induced abortion group of non-viable outcome, low birthweight and shortened gestation, could have arisen by chance. Further analysis of a larger number of pregnancies is required to permit confident interpretation of these observations. The present data provide no reason for alterations in the current management of induced abortion, or the subsequent pregnancy.

Abortion, Induced↗
PubMed1984

The Royal College of General Practitioners' Oral Contraception Study: some recent observations.

The Royal College of General Practitioners' Oral Contraception Study is a continuing cohort survey of the effects of oral contraceptives on the health of users. Neurotic depression is associated with the oestrogen content of combined oral contraceptives, but the risk is small in general, and there is no excess risk associated with oestrogen doses of 35 micrograms or less. It now appears likely that, in the long-term, oral contraceptives are not associated with any increased risk of gallbladder disease, although there is an acceleration of the disease in those women susceptible to it. The progestogen activity of combined oral contraceptives is associated with an increased risk of hypertension and arterial disease. Duration of use no longer seems to influence the occurrence of the latter. Cigarette smoking by oral contraceptive users is the predominant associated risk factor for the occurrence of arterial diseases. Non-smokers using low-progestogen-dose brands may safely use oral contraceptives, probably up to the age of 45 years. In the author's opinion, there is no convincing evidence that oral contraceptive use increases the risk of breast cancer. The evidence for an association with cervical cancer is firmer, but, if confirmed, is unlikely to affect more than one in 3000 users a year. Increased safety in the use of oral contraceptives in future is likely to be achieved through the use of tests which will allow the adjustment of dose to be made to each patient's particular requirements.

Adolescent↗
PubMed1982

Progestogens and arterial disease--evidence from the Royal College of General Practitioners' study.

In the course of a large-scale prospective study of the health of oral contraceptive users, the rate of reporting of arterial diseases was examined in two groups of users of pill brands that permitted the effect of the progestogen to be assessed independently of estrogen effect. The rate of reporting was consistently higher with the brands with the higher progestogenic activity. The reports of cerebrovascular diseases showed a significant trend in relation to the dose of norethindrone acetate as well as in relation to total arterial diseases. Total arterial diseases were also reported more frequently in association with brands containing 250 microgram of levonorgestrel than with those containing 150 microgram of this progestogen. The mean serum levels of high-density lipoprotein cholesterol in users of the brands described show a striking inverse relationship to the rate of reporting of arterial diseases and to the progestogenic activity of the pills.

Adult↗
PubMed1981

Comparison of cause of death coding on death certificates with coding in the Royal College of General Practitioners Oral Contraception Study.

A comparison has been made between the coding of the cause of death by (a) the Royal College of General Practitioners (RCGP) during the Oral Contraception Study and (b) the Office of Population Censuses and Surveys (OPCS) or the General Register Office for Scotland (GRO) on death certificates for the same subjects. Broad grouping of the International Classification of Diseases (ICD) showed close agreement between RCGP and OPCS or GRO coding for all deaths which occurred from the start of the Oral Contraception Study in 1968 up to December 1978. Moreover, where discrepancies occurred there were no systematic differences between ever-users of oral contraceptive and non-users. Detailed examinations of discrepancies in the coding of the causes of those deaths included in the RCGP publication of October 1977 shows that our previous estimate of mortality risk associated with oral contraceptives would not be materially altered by the use of death certificate information.

Cardiovascular Diseases↗
PubMed1981

Characteristics of women recruited to a long-term study of the sequelae of induced abortion. Report from a joint RCGP/RCOG Study co-ordinated by the Royal College of General Practitioners' Manchester Research Unit.

One thousand, five hundred and nine general practitioners and 795 gynaecologists are co-operating in a large, long-term, controlled, prospective study of the sequelae of induced abortions. The ;case' (6,349 patients) and control (8,132 patients) groups are comparable, and the patients who had induced abortion are also comparable in age, marital status and parity with those in the national abortion statistics. The study should, therefore, give a sound basis for evaluating the long-term hazards of the operation.

Abortion, Induced↗