Birth control linked to 20% higher risk of breast cancer

Katherine Streeter for NPR

Even newer lower-dose birth control pills raise a woman's risk of breast cancer, although the actual danger is "quite small", researchers reported Wednesday. Therefore, it wasn't clear if this risk applied to newer formulations of birth control pills or to other birth control methods, including intrauterine devices (IUDs) and implants that contain only the hormone progestin.

A hormone specialist at Brigham and Women's Hospital who deals with contraceptive issues says the study shouldn't alarm those taking oral contraceptives.

But they stress there is no need for most women to abandon birth control pills for fear of breast cancer.

Overall, there was one extra case of breast cancer for every 7,600 women using hormonal contraception for a year. "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.

This study was done in Denmark, where every resident is on a register of medical visits and drug purchases.

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".

Overall, the use of any hormone-based contraceptive for five years or more raised a woman's risk of breast cancer by 20 percent, Lina Morch of the University of Copenhagen and colleagues reported in the New England Journal of Medicine. Exclusion criteria included women with venous thromboembolism, history of cancer excluding nonmelanoma skin cancer, and a history of infertility treatment.

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Breast cancer strikes about 255,000 US women each year and kills about 41,000, according to the American Cancer Society. 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.

"There were hopes that the new formulations would not increase a user's risk of breast cancer as the older formulations did", said Mia Gaudet, strategic director of breast and gynecologic cancer research at the American Cancer Society, who was not involved in the research.

"Unfortunately this was not the case and additional research is needed to tweak the formulation". "But it does show an increased risk, so for people who don't have a great reason for taking oral contraceptives, or are amenable to alternatives, perhaps they should think about it".

Not only that, but there are plenty of non-hormonal birth control options to consider, like the non-hormonal IUD, diaphragm and condoms - and let's not forget vasectomies.

Because the best choice is always the informed one.

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. Over the years, makers of birth control pills and hormone replacement therapy for women past menopause have reduced the amount of estrogen in their products.

The first wave of birth control pills contained doses as high as 150 micrograms of estrogen. 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. "The range of risks we're talking about here is much much smaller", she said.

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