A case-control study of hepatocellular adenoma (HCA), a serious though nonmalignant liver tumor, was conducted by the Center for Disease Control and the Armed Forces Institute of Pathology (AFIP). Interviews with 79 women with HCA and with 220 age- and neighborhood-matched controls were completed. Limited information was obtained on nine additional patients who had died. Women with HCA and hemorrhage have a greater risk of morbidity and death than those with other symptoms. Increasing duration of OC use increases the risk of HCA. Use of OCs with high hormonal potency and age over 30 years may further increase a woman's risk of HCA. Long-term users of OCs have an estimated annual incidence of HCA of 3 to 4 per 100,000.
Widespread publicity in the mass media about the dangers of leaving an IUD in place in a pregnant uterus was apparently more effective than traditional scientific publication and drug package inserts in getting doctors to remove devices from pregnant patients. This suggests that such publicity could be effective in improving clinical practice and the public health in other instances, such as getting doctors to prescribe and women to request birth control pills with lower doses of estrogen, and persuading women to obtain early rather than the riskier midtrimester abortions.
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