Last Updated: December 06, 2017. 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.
While contraceptive drugs that contain oestrogen have always been suspected of increasing the likelihood of breast cancer, researchers had expected smaller doses of the hormone, often combined with the drug progestin, would be safer, said Lina Morch, an epidemiologist at Copenhagen University Hospital who led a study analysing the records of 1.8 million women in Denmark.
Those who used them for longer periods were at even greater risk. Newer birth control drugs developed to replace those tied to cancer risk were thought to improve safety for the women who took them.
Breast cancer strikes about 255,000 US women each year and kills about 41,000, according to the American Cancer Society.
"There had been some changes to oral contraceptive formulations in the '90s, and there was the hope those formulations would result in a lower risk of breast cancer", said Gaudet, who was not part of the study.
Morch and Gaudet noted that breast cancer is relatively uncommon in younger women, so a young woman's overall risk of breast cancer still is low, even if she's taking the pill.
What those numbers mean in terms of actual women getting breast cancer who otherwise may not have is a bit less striking: there was about one extra breast cancer case diagnosed for every 7690 women who used hormonal contraception for a year.
"It's a 20 percent increase in risk, but the absolute risk is very low", Dr. Joann Manson said.
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"The relative risk increase in this study is only 1.2 on average".
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.
The bottom line is that before starting or continuing to take hormonal contraceptives - or any medications - it's important to speak with your doctor about any potential risks and benefits, and make an informed decision from there. 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. They also contain progestin, a synthetic form of the female hormone progesterone, which helps regulate the monthly menstrual cycle. That's a lot of cancers, given that 140 million use hormonal contraception worldwide - or about 13 percent of women ages 15 to 49.
"In the 1980s and 1990s, there was some optimism regarding the development of a formulation that would reduce a woman's risk of breast cancer", he said in the commentary, "but research into this possibility appears to have stalled".
First, the study didn't factor in other variables like diet, physical activity, breastfeeding or alcohol consumption, which could also have an impact on developing breast cancer.
Mørch explained to MedPage Today that "there was a lack of evidence on contemporary hormonal contraception and risk of breast cancer". Novo Nordisk Foundation funded the research, but played no role in designing the study.
Officials with the American College of Obstetricians and Gynecologists said that they would carefully evaluate the new findings, but emphasized that hormonal contraceptives are for many women "among the most safe, effective and accessible options available".
Use of oral contraceptives may increase risk of breast cancer, although the overall absolute increase for breast cancer cases was relatively small. Women who used any form hormonal contraception for more than 10 years (1.38, 95% CI 1.26-1.51) had a higher risk compared to those who reported less than 1 year of use (1.09, 95% CI 0.96-1.23)(P=0.002), they wrote online in the New England Journal of Medicine.
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