Many modern contraceptives still linked to breast cancer

Even New Birth Control Pills May Raise Women's Breast Cancer Risk

A study published Wednesday has linked newer-generation birth control pills with breast cancer; the link had already been established for older variants of hormonal contraception.

Researchers in Denmark analyzed data on 1.8 million women and found that using any type of hormonal contraceptive was linked to a 20-percent higher risk of breast cancer.

One thing reiterated by every doctor Newsweek spoke to: Women who are anxious about how their contraception might increase their risk of breast cancer should speak with their health care provider.

"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.

Breast cancer is the second-biggest cancer killer of American women, after lung cancer.

Hormone-infused devices such as vaginals rings, implants and some IUDs also appear to raise the risk, although again not by much, the study found.

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Researchers accounted for education, childbirth and family history of breast cancer, but they weren't able to adjust for several other known cancer risk factors such as alcohol use and limited physical activity, or protective factors such as breast-feeding.

The new findings, reported in The New England Journal of Medicine, show that they do not, and the longer the products were used, the greater the danger.

On the other hand, among women who used hormonal contraceptives for short periods, the excess risk of breast cancer disappeared rapidly after use was stopped, the researchers said. But according to a new study, even the contraceptives with lower dosages of estrogen still come with a slightly increased chance of breast cancer.

"The risk increases with increasing duration of use and persists for more than five years, if used for longer than five years", said study author Lina Morch, a senior epidemiologist with the University of Copenhagen in Denmark. After all, it means that almost a quarter of American women are doing something that might increase their risk of developing breast cancer by a third-in theory.

Shirazian notes that for women of average risk of breast cancer, the concern is not high. As research began to link estrogen to breast cancer, the FDA took off the market any formulations that had more than 50 micrograms of estrogen, Gaudet said.

The study shows that "the search for an oral contraceptive that does not elevate the risk of breast cancer needs to continue", said Dr. David Hunter of the University of Oxford in a Journal editorial.

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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.

Such alternatives include a copper IUD, condoms or, if women are done having children, tubal ligation.

Experts noted that oral contraceptives have some benefits as well, and are associated with reductions in ovarian, endometrial and possibly colorectal cancers later in life. Still, the additional risk would result in a comparatively few additional cases of breast cancer, the researchers said.

A 20 per cent increase in relative risk may be small in absolute terms, but the calculation changes with age.

Today, most versions of the pill contain between 15 and 35 micrograms of estrogen, Gaudet said.

Mørch explained to MedPage Today that "there was a lack of evidence on contemporary hormonal contraception and risk of breast cancer". Don't forget there is relative risk of death in pregnancy, too. That roughly translates to a 12 percent lifetime risk for a woman, although many factors affect breast cancer risk. But he suggested doctors take time to discuss the pros and cons of different types of contraception with their patients, and that they be frank about the potential risks, suggesting women reassess hormone use as they age.

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