Birth control linked to 20% higher risk of breast cancer

Katherine Streeter for NPR

Whether it's the pill, the patch, or a range of other products, millions of women today use hormonal contraceptives; so it's little surprise that a new study shows that those who take them have an increased risk of breast cancer.

Women who now use or recently used hormone-based contraception face a 20 percent higher risk of breast cancer, although the overall risk for most women is relatively low, a new study of 1.8 million women in Denmark has concluded.

The longer women used hormonal contraception, the greater their risk of breast cancer, the researchers found. But, the overall risk remains small, and past research suggests oral contraceptives protect against other types of cancer.

There are also numerous potential health benefits of hormonal contraceptives beyond preventing pregnancy, including decreasing the risk of endometrial, ovarian and colorectal cancers, as well as helping with menstrual cycle regularity, migraines and acne. "We see from this data that is not the case".

"When we look at all comers, the absolute overall increased risk of breast was one extra case of breast cancer for every 7,690 women using hormonal contraception for one year", said Dr. Rebecca Starck, a gynecologist at the Cleveland Clinic.

Once women stopped using these forms of birth control, the increased risk of breast cancer disappeared if the women had used hormonal contraception for less than five years.

And the latest study only showed an association - it did not prove that taking the newer versions of the pill actually caused breast cancer risk to rise.

"Women in that age group [already] have a very low absolute risk of breast cancer", Gaudet said. "Taking a very low absolute risk and increasing it only slightly is still a relatively low risk".

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Two types of birth control pills are sold in the US - one that combines synthetic versions of the hormones estrogen and progesterone, and the "minipill" that only delivers progestin, a synthetic formulation of progesterone.

The new study "confirms that the increased breast cancer risk. that was initially reported with the use of older, often higher-dose formulations also applies to contemporary formulations" of birth control, David Hunter, a professor of epidemiology and medicine at Oxford University's Nuffield Department of Population Health in the United Kingdom, wrote in an editorial that accompanied the study. "Thus, it is not exclusively estrogen that increases the risk of breast cancer".

Duration of use also contributed to associated breast cancer risk.

Mørch said that "knowledge is needed on the potential beneficial influence of newer contraceptives on the risk of ovarian and colorectal cancer, since evidence now relates to older types of hormonal contraceptives". "It has been known that progesterone probably plays a role in breast cancer, although our research is not as mature as it is for estrogen". In the meantime, women who are using oral contraceptives might want to speak to their doctors about use before age 35 and after age 35.

The data are "a gold mine for doing these kinds of analyses", she said.

The new study was published December 7 in the New England Journal of Medicine.

Lindegaard speculated that the hormones in birth control may trigger certain cells that are ready to turn into cancer, he said, given that the risk seems to increase after only a few months of use.

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