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2. Contemporary Hormonal Contraception and the Risk of Breast Cancer

Author

Mørch, Lina S, Hannaford, Philip C, and Lidegaard, Øjvind

Subjects
Biomedical and Clinical Sciences, Health Sciences, Breast Neoplasms, Contraception, Contraceptives, Oral, Hormonal, Humans, Risk, Medical and Health Sciences, General & Internal Medicine, Biomedical and clinical sciences, Health sciences
Published
2018

3. Contraception Cancer Risks and Benefits

Author

Hannaford, Philip C., Iversen, Lisa, Jannini, Emmanuele A., Series Editor, Foresta, Carlo, Series Editor, Lenzi, Andrea, Series Editor, Maggi, Mario, Series Editor, Meriggiola, Maria Cristina, editor, and Gemzell-Danielsson, Kristina, editor

Published
2021
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6. Determinants of stroke in women

Author

Hannaford, Philip Christopher

Subjects
610, Contraceptive pill
Abstract

The effect of a number of possible risk factors for stroke were examined in a nested case-control study of participants in the prospective Royal College of General Practitioners' Oral Contraception Study. The case were 253 women who had a first ever stroke or episode of amaurosis fugax between 1968 and 1990. Three age-matched controls were selected for each case. Current users of the pill had an increased risk of total and fatal stroke. Former users had a small elevated risk of total stroke and a stronger risk of fatal stroke. The effects in former users appeared to be restricted to women who smoked. The elevated risk of total stroke among former users appeared to diminish with time although a persisting risk of fatal or haemorrhagic stroke could not be excluded. Smoking increased the case fatality rates of pill users who had a stroke. The effects of the pill in women with other factors for stroke were explored, but were inconclusive. The newer oral contraceptives were associated with a lower risk of stroke than older preparations, a benefit which has occurred because of changes in pill formulation rather than more selective prescribing by doctors. Smoking enhanced the risk of cerebrovascular disease in hypertensive, and possibly diabetic, women. The largest population attributable proportions were associated with smoking (36%), ever use of oral contraceptives (23%), manual social class (21%) and hypertension (19%). The successful elimination of cigarette smoking must remain a public health priority.

Published
1994

9. Markers for Persistent Specific Expressive Language Delay in 3-4-Year-Olds

Author

Everitt, Andrea, Hannaford, Philip, and Conti-Ramsden, Gina

Abstract

Background: Identifying 3-4-year-olds who are most at risk of persisting language difficulties, and possibly specific language impairment (SLI), is difficult due to the natural variation of language in young children. In older children, markers for SLI have been identified that differentiate between children with and without SLI. It is not known whether these markers can be used at an earlier age to identify children most at risk of persisting language difficulties. Aims: To identify possible risk markers of current status that distinguish children who have specific expressive language delay (SELD) from the variation observed in normally developing children at age 3;0-4;0 and 4;0-5;0. To determine the most suitable measure(s) that would predict which children with SELD at age 3;0-4;0 were likely to have persistent expressive language delay (PELD) at age 4;0-5;0. Methods & Procedures: Forty-seven children with SELD and 47 children with typical language development (TLD) were assessed on language, nonverbal IQ and marker tasks at age 3;0-4;0 (baseline). Ninety-one children were reassessed on the measures one year later (follow-up). At both time points, the marker tasks were compared with a reference standard (Expressive Communication subscale (EC) of the Preschool Language Scale-3 (PLS-3) (UK)) to determine the most useful marker for identifying children with SELD. Possible predictors were examined to determine the most suitable measure(s) that would predict which children with SELD at baseline were likely to have PELD at follow-up. Outcome & Results: A modified version of Recalling Sentences, a subtest of the Clinical Evaluation of Language Fundamentals (CELF)-Preschool UK, was the most useful marker for identifying children with SELD at baseline and at follow-up. Thirty-five (76.1%) of the 46 children with SELD at baseline had PELD at follow-up. Performance on the Auditory Comprehension (AC) and EC subscales of the PLS-3 (UK) and on modified Recalling Sentences at age 3;0-4;0 were predictors of PELD at age 4;0-5;0. Conclusions & implications: A modified Recalling Sentences task was a good risk marker for SELD at age 3;0-4;0 and SELD at age 4;0-5;0. PLS-3 AC, PLS-3 EC and modified Recalling Sentences at baseline were the best predictors of PELD. The use of modified Recalling Sentences as a predictive marker requires confirmation.

Published
2013
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14. Authors' reply

Author

Hannaford, Philip C, Iversen, Lisa, Macfarlane, Tatiana V, Elliott, Alison M, Angus, Valerie, and Lee, Amanda J

Published
2010

43. Maintaining musculoskeletal health using a behavioural therapy approach: a population-based randomised controlled trial (the MAmMOTH Study)

Author

Macfarlane, Gary J, Beasley, Marcus, Scott, Neil, Chong, Huey, McNamee, Paul, McBeth, John, Basu, Neil, Hannaford, Philip C, Jones, Gareth T, Keeley, Phil, Prescott, Gordon, Lovell, Karina, Macfarlane, Gary J, Beasley, Marcus, Scott, Neil, Chong, Huey, McNamee, Paul, McBeth, John, Basu, Neil, Hannaford, Philip C, Jones, Gareth T, Keeley, Phil, Prescott, Gordon, and Lovell, Karina

Abstract

Objective: Cognitive–behavioural therapy (CBT) has been shown to be effective in the management of chronic widespread pain (CWP); we now test whether it can prevent onset among adults at high risk. Methods: A population-based randomised controlled prevention trial, with recruitment through UK general practices. A mailed screening questionnaire identified adults at high risk of CWP. Participants received either usual care (UC) or a short course of telephone CBT (tCBT). The primary outcome was CWP onset at 12 months assessed by mailed questionnaire. There were seven secondary outcomes including quality of life (EuroQol Questionnaire-five dimensions-five levels/EQ-5D-5L) used as part of a health economic assessment. Results: 996 participants were randomised and included in the intention-to-treat analysis of which 825 provided primary outcome data. The median age of participants was 59 years; 59% were women. At 12 months there was no difference in the onset of CWP (tCBT: 18.0% vs UC: 17.5%; OR 1.05; 95% CI 0.75 to 1.48). Participants who received tCBT were more likely to report better quality of life (EQ-5D-5L utility score mean difference 0.024 (95% CI 0.009 to 0.040)); and had 0.023 (95% CI 0.007 to 0.039) more quality-adjusted life-years at an additional cost of £42.30 (95% CI −£451.19 to £597.90), yielding an incremental cost-effectiveness ratio of £1828. Most secondary outcomes showed significant benefit for the intervention. Conclusions: A short course of tCBT did not prevent onset of CWP in adults at high risk, but improved quality of life and was cost-effective. A low-cost, short-duration intervention benefits persons at risk of CWP. Trial registration number: ClinicalTrials.gov Registry (NCT02668003).

Published
2021

44. Contemporary hormonal contraception and cervical cancer in women of reproductive age

Author

Iversen, Lisa, Fielding, Shona, Lidegaard, Øjvind, Hannaford, Philip C., Iversen, Lisa, Fielding, Shona, Lidegaard, Øjvind, and Hannaford, Philip C.

Abstract

To determine cervical cancer risk associated with contemporary hormonal contraceptives, we conducted a cohort study of women aged 15 to 49 living in Denmark from 1995 to 2014, using routinely collected information about redeemed prescriptions, incident cancer and potential confounders. Poisson regression calculated adjusted cervical cancer risks among different contraceptive user groups by duration of use, time since last use, hormonal content and cancer histology. During >20 million person-years, 3643 incident cervical cancers occurred. Ever users of any hormonal contraceptives compared to never users had a relative risk (RR) of 1.19 (95% confidence interval [CI] 1.10-1.29). Increased risks were seen in current or recent users of any hormonal: RR 1.30 (95% CI 1.20-1.42) and combined: RR 1.40 (95% CI 1.28-1.53), but not progestin-only contraception: RR 0.91 (95% CI 0.78-1.07). Current or recent users of any hormonal contraception had an increased risk of both adenocarcinoma (RR 1.29, 95% CI 1.05-1.60) and squamous cancer (RR 1.31, 95% CI 1.19-1.44). The risk pattern among any hormonal and combined contraceptive users generally increased with longer duration of use and declined after stopping, possibly taking longer to disappear among prolonged users. Combined products containing different progestins had similar risks. Approximately one extra cervical cancer occurred for every 14 700 women using combined contraceptives for 1 year. Most women in our study were not vaccinated against human papillomavirus (HPV) infections. Our findings reinforce the urgent need for global interventions such as systematic screening, treatment of cervical intraepithelial neoplasia and HPV vaccination programmes to prevent cervical cancer, especially among users of combined contraceptives.

Published
2021

46. Maintaining musculoskeletal health using a behavioural therapy approach: a population-based randomised controlled trial (the MAmMOTH Study)

Author

Macfarlane, Gary J, primary, Beasley, Marcus, additional, Scott, Neil, additional, Chong, Huey, additional, McNamee, Paul, additional, McBeth, John, additional, Basu, Neil, additional, Hannaford, Philip C, additional, Jones, Gareth T, additional, Keeley, Phil, additional, Prescott, Gordon J, additional, and Lovell, Karina, additional

Published
2021
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