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The Breast Cancer and Contraceptive Pill Link: Let’s Have Some Context

The Breast Cancer and Contraceptive Pill Link: Let’s Have Some Context

New research suggests what at first glance is a startling increase in the chances of developing breast cancer if a woman uses the particularly high-estrogen versions of the contraceptive pill, but it’s important to put these findings in context.

Researchers from the American Association for Cancer Research, publishing in the journal Cancer Research, looked at the health data and contraceptive history of more than 1,000 women sampled from 1990 to 2009 who used birth control pills and had been diagnosed with invasive breast cancer between the ages of 20 and 49. They compared that with the data of 21,952 women who had never had breast cancer.

The media has turned what those researchers found into a scary sounding statistic: that women who used contraceptive pills were, on average, 50 percent more likely to develop (estrogen receptor-positive) breast cancer than those who had never used oral contraceptives or who had ceased using them 10 years ago. The strongest link was found with high dose estrogen formulation pills. These make up less than one percent of prescriptions filled in the study, but could be linked to a high number of cases. On the other hand, low dose estrogen pills appeared to lead to no elevated breast cancer risk.

The researchers are keen to stress that there are a number of qualifiers for this research:

“Given that these results have not yet been confirmed, and the importance of assessing the many established benefits of oral contraceptives as well as the risks, we are not able to give any clinical recommendations based on this study,” study author Elisabeth F. Beaber is quoted as saying. “It’s an intriguing finding, but there really do need be larger studies with larger sample sizes in different populations to really confirm if these results hold up.”

Contraception opponents will likely seize on this research as proof for their claims that women are at a significant risk of cancers as a result of contraceptives. We should point out, though, that this link isn’t a new finding, and even if it were, the numbers we are talking about are relatively low.

A 1996 analysis of 50 studies by the Collaborative Group on Hormonal Factors in Breast Cancer found that women who were current users of contraceptive pills or had used the contraceptives in the past ten years were more likely to develop breast cancer than those who hadn’t, with the highest risk among women who had continued use since their teenage years. Yet, if the women ceased using oral contraceptives and did not develop breast cancer within ten years, they were no more likely to develop cancer than their non-contraceptive using counterparts after that period.

There are other pieces of research that suggest that the so-called “triphasic” contraceptive regimen slightly increases breast cancer risk, but that finding must be confirmed with multiple trials using larger population samples to confirm the link and ascertain just how strong the connection might be.

This supports what the most recent research suggests: that the formulation of the contraceptive may play a part in the increased cancer risk. It’s also important to unpack the rather startling 50 percent statistic and say how that translates to real-world risk. The increase sounds dramatic but if we consider the thousands of women involved in this study, we begin to put the statistic in context.

For instance, an increase of one woman per 100,000 to two women per 100,000 contracting breast cancer would represent a doubling of the risk but would at the same time represent a very small real-world increase. An exact figures for the increase in breast cancer risk isn’t currently known (different studies offer different but always small increases) but this perhaps suggests how that 50 percent figure might be misleading.

There is also the often barely discussed fact that the contraceptive pill has demonstrated a significant link with lowered risks of ovarian cancer, something that is worth mentioning because that effect is actually quite pronounced and long-lasting, with protection extending even a decade after a woman stops using the pill.

In short, this new research is indeed welcome because it helps to confirm what we already knew. However, it shouldn’t deter women from taking the contraceptive pill. Instead, talking through the health options with a doctor who can discuss both the risks and the benefits of using the contraceptive pill is still recommended because, for most women, the pill is still a sound family planning option.

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Photo credit: Thinkstock.

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121 comments

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8:38AM PDT on Aug 24, 2014

I'm 63 years and remember that this discussion is taking place for about 30 years. First of all, one should consider the occurrence of breast cancer in your family. if your mother, her mother, sisters, aso. had breast cancer, it is much likely that you will also get breast cancer. That's why in Holland (Europe) already many women prefer amputation of their breast because it is accepted legally and also refunded by the Health Insurance. But I would like to add that taking hormones or medication for decades is not favorable for our body and can develop a type of cancer or more commonly problems with liver and kidneys. Furthermore, approximately simultaneously the contraceptive pill and use of hormones in meat, later on fish culture took place. Then do we all have to stop eating meat and dairy products and what chemicals is being used nowadays in the production of vegetables, fruits, nuts, etc. It is of course not pleasant to get breast cancer, but having unwanted children is not the solution either. It is because of overpopulation that billions of trees have to render their place (and their habitants) for agricultural products, viz. wheat, corn, sugar, rice.... I'm also confused that after about 50 years the medical world is still not certain whether or not the contraceptive pills is the cause of a certain percentage of breast cancer. About 30/40 years ago people already spoke about it, and now 2 generations later, they still are in the dark ??

11:35PM PDT on Aug 16, 2014

Thanks for the information.

10:38PM PDT on Aug 16, 2014

Thanks

10:30AM PDT on Aug 11, 2014

i am not surprised at all.......

9:14AM PDT on Aug 11, 2014

thanks

4:10AM PDT on Aug 11, 2014

ty

10:43PM PDT on Aug 10, 2014

Thanks

6:18PM PDT on Aug 10, 2014

Unintended pregnancies and abortion are likely more deleterious to one's health than the pill!

12:57PM PDT on Aug 10, 2014

thanks for the interesting article

10:10AM PDT on Aug 10, 2014

Most of this I have read before, but there are still not enough stats out there to prove HTR or BC's are the direct cause of Breast CA.

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