Small risk of breast cancer seen with hormone contraceptives

Small risk of breast cancer seen with hormone contraceptives

Those dangers are somewhat offset by reduced risks of cancer - of the ovaries, endometrium, and digestive system - that other studies have linked to birth control pills, according to David Hunter, an Oxford University epidemiologist who wrote a commentary on the study.

"We always thought that non-oral hormonal contraception like the IUD is more of a localized form and systemically didn't affect women in the same way". Another way of looking at that is that there would be one additional case of breast cancer each year among 7,700 people who use hormonal contraceptives. "Contraception itself is a benefit, of course, but this study indicates it might be worth considering an alternative to hormone contraception, like the copper intrauterine device or barrier methods like condoms".

They found that women taking estrogen/progestin birth control pills have about a 20 percent increased risk of breast cancer.

"Gynecologists just assumed that a lower dose of hormone meant a lower risk of cancer". "It's small but it's measurable, and if you add up all the millions of women taking the pill, it is a significant public health concern", Weiss added.

"They shouldn't necessarily change what they're doing", Gaudet said.

Women should discuss their contraceptive options with their doctor or gynecologist, Gaudet and Morch said.

He also added the risks associated with hormonal contraception must be weighed against the benefits.

Breast cancer is the second-biggest cancer killer of American women, after lung cancer. "It's important that women feel confident and comfortable with their contraceptive choice", he said.

They include smoking, obesity, starting menstruation early, having children late in life or not at all and not breastfeeding.

Results were published Wednesday in the New England Journal of Medicine.

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It's a disappointment to doctors who had hoped that lower doses of hormones in both oral and non-pill contraceptives might be safer than older birth control pills. Most cases of breast cancer were seen in women using oral contraceptives in their 40s. According to an editorial that accompanied the study in NEJM, birth control may actually be protective against cancer on the whole despite this increased risk for one type.

"It's a 20 percent increase in risk, but the absolute risk is very low", Dr. Joann Manson said.

The study, which used all of Denmark as its sample, followed almost 1.8 million women of childbearing age for over a decade on average, drawing data from national prescription and cancer registries.

Breast cancer data was collected from the Danish Cancer Registry. "Indeed, some calculations have suggested that the net effect of the use of oral contraceptives for 5 years or longer is a slight reduction in the total risk of cancer", Hunter said.

"Progestin-only products also increased the risk of breast cancer", Morch noted. It amounted to one extra case of breast cancer among 7,700 women using hormone contraceptives per year. Out of those women, for every 100,000 participants, the use of hormonal birth control caused an additional 13 cases of breast cancer each year. The findings indicate that the hormone progestin is adding to breast cancer risk; some of the contraceptive pills and numerous IUDs included only progestin, Mørch said.

"The relative risk increase in this study is only 1.2 on average". Any woman's risk of breast cancer goes up as she gets older. Don't forget there is relative risk of death in pregnancy, too. But by the time a woman reaches 40, her probability of developing breast cancer in the next 10 years is 1.45 per cent, or 1 in 69. "In particular the knowledge of risk with newer progestins was sparse". That roughly translates to a 12 percent lifetime risk for a woman, although many factors affect breast cancer risk.

Mørch explained to MedPage Today that "there was a lack of evidence on contemporary hormonal contraception and risk of breast cancer".

The new study looked at all women in Denmark ages 15 to 49 who had not had cancer, clots in their veins, or treatment for infertility.

"Nothing is risk-free, and hormonal contraceptives are not an exception to that rule", said Dr. Øjvind Lidegaard, the paper's senior author.

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