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Objective: To describe the long term effects of the use of oral contraceptives on mortality.

Design: Cohort study with 25year follow up. Details of oral contraceptive use and of morbidity and mortality were reported six monthly by general practitioners. 75% of the original cohort was “flagged” on the NHS central registers.

Setting: 1400 general practices throughout Britain.

Subjects: 46000 women, half of whom were using oral contraceptives at recruitment in 1968-9.Median age at end of follow up was 49 years.

Main outcome measures: Relative risks of death adjusted for age, parity, social class, and smoking.

Results: Over the 25year follow up 1599deaths were reported. Over the entire period of follow up the risk of death from all causes was similar in ever users and never users of oral contraceptives (relative risk=1.0, 95% confidence interval 0.9 to 1.1; P=0.7) and the risk of death for most specific causes did not differ …