Even Low-Dose Contraceptives Slightly Increase Breast Cancer Risk

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WEDNESDAY, Dec. 6, 2017 (HealthDay News) - Newer versions of the birth control pill carry a similar increased risk of breast cancer as earlier ones that were abandoned in the 1990s, a new study reveals. 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.

Women taking modern formulations of the pill have a 20 percent increased risk of breast cancer compared with those who've never been on hormonal contraception, the study of nearly 2 million Danish women found. They were looking to see what happened over a stretch of almost 11 years among women who used hormonal birth control - usually a combination of estrogen and progestin - versus women who relied on non-hormonal contraceptive methods, such as a condom, diaphragm or copper IUD.

The 20 percent increase in breast cancer risk varied by age and how long the women used hormone-based contraceptives, including pills, contraceptive patches, vaginal rings, progestin-only implants, and injections.

The researchers calculated that hormone contraception produced one extra case of breast cancer for every 7,690 women each year.

Compared to what the group of researchers found in one of their other papers-that using hormonal contraception was associated with a 300 percent increase in suicide risk-"it is a modest increase", said Dr. Øjvind Lidegaard, one of the authors of the paper and a gynecologist at the University of Copenhagen.

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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.

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.

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.

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

To see whether the lower amounts of estrogen helped reduce or eliminate the added breast cancer risk, Morch and her colleagues tracked about 1.8 million women from 1995 through 2012.

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Digging further, the researchers found no differences among types of birth control pills. About 40,000 women died of breast cancer in 2017.

But the study did not account for some other things that affect breast cancer risk, including physical activity levels and alcohol consumption. Still, the additional risk would result in a comparatively few additional cases of breast cancer, the researchers said. Relative to the increased risk posed by other environmental factors, like smoking for lung cancer-that's about a 10 times greater risk-and having a human papillomavirus infection for cervical cancer-that may increase risk about 50 or 60 times-38 percent really isn't that much. "So, many calculations suggest that the use of oral contraceptives actually prevents more cancers than it causes". For a 20-year-old woman, for example, the probability of developing breast cancer in the next 10 years is 0.06 per cent, or 1 in 1,732, according to breastcancer.org.

In Denmark, older women who have completed their families are most likely to use IUDs, including those containing hormones, and they are already more likely to develop breast cancer because of their age, Mørch said.

It's always been known that hormonal contraception, like any medicine, carries some risks. 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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