What To Make Of It All
When it comes to cancer, there are some things that the evidence clearly points to. For instance, the relationship between smoking and cancer is unequivocal. Smoking is responsible for one in four cancer deaths in the UK.
Likewise, theres a clear link between bodyweight and cancer and ovarian cancer is more common among women who are overweight. So making sure you keep a healthy bodyweight and quit smoking are both good things to do if you are worried about your cancer risk.
Others recommendations need to be more subtly nuanced and made on an individual basis.
Your doctor can help you to make an informed choice about whether to use the Pill. This decision should first consider whether its a suitable form of contraceptive for you, and also account for the known risks and benefits of using the Pill, your lifestyle, your personal beliefs and preferences, and whether you have a strong family history of cancer or certain other diseases.
And while were talking of risk, lets not forget what the Pill was designed to do: its 99.7 per cent effective at preventing unwanted pregnancies when used correctly a benefit that must also be weighed against any potential risks.
Olly Childs
Reference
- Tsilidis, K. et al . Oral contraceptive use and reproductive factors and risk of ovarian cancer in the European Prospective Investigation into Cancer and Nutrition British Journal of Cancer, 105 , 1436-1442 DOI: 10.1038/bjc.2011.371
Nonhormonal Iuds Are A Good Option For Women With Breast Cancer
Birth control pills and hormonal IUDs are generally not good options for women with hormone-sensitive cancers, such as breast cancer, because they may stimulate the growth of tumor cells, says Dr. Goldfrank. They can also increase the risk of other health problems, including blood clots and stroke. Its important to talk with your oncologist if you are diagnosed with a hormone-sensitive cancer to better understand the health risks and benefits of birth control.
However, says Dr. Goldfrank, Nonhormonal IUDs are not thought to increase cancer risk. And studies have indicated that copper IUDs might actually reduce your risk of cervical and endometrial cancer. Were not certain why.
Hormones: Yin And Yang
Estrogen and progestogens are essential steroid hormones. In women, they are required for normal development of female sex organs and secondary sex characteristics, regulation of the menstrual cycle and reproduction, and many other essential physiological functions in the bones, brain, breasts, adipose tissue, and uterus.
However, many epidemiological studies have shown that prolonged exposure to estrogens may increase the risk of breast cancer. Longer lifetime exposure to high levels of these hormones due to early age at first menstruation and late age of menopause has been associated with increased risk of breast cancer . Similarly, epidemiological observational studies and the Womens Health Initiative clinical trial have shown that the combination estrogen and progestogen hormone therapy used to treat menopausal symptoms and osteoporosis in post-menopausal women increases the risk of breast cancer .
Figure 3 ~ Estrogen and progestogens are required for normal development and function of multiple tissues. However, estrogen can also promote breast cancer development mostly via activation of growth factor pathways that prompt cells to divide. Images from .
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How Can The Combined Pill Increase My Risk Of Cancer
Taking the combined pill is associated with an increased risk in some cancers, such as breast and cervical cancer. But taking the combined pill can reduce the risk of other cancers, such as ovarian, womb and bowel cancer.
Those taking the combined contraceptive pill over long periods of time may have a slightly increased risk of breast cancer and cervical cancer. According toBreast Cancer Now, in a group of 10,000 women who do not use the combined pill, about 40 will probably develop breast cancer between the ages of 30 and 39.
In a group of 10,000 women who do use the combined pill for most of their 30s, about 54 will develop breast cancer between the ages of 30 and 39. So using the combined pill during this time causes about 14 extra cases of breast cancer in every 10,000 women.
The link between the pill and breast cancer risk is not yet clear, but it is thought the hormones in the combined contraceptive pill can increase the growth of some breast cancers.
This risk falls again once you stop taking the combined contraceptive pill, and 10 years after stopping, the persons risk is no longer increased.
If you have the faulty BRCA genes, you are already at high risk of breast and ovarian cancer, so taking the combined pill is an added risk.
Cancer Is Partly Caused By Bad Luck Study Finds
Unlike most previous research, this study didnât just track the effect of birth control pills. Because their set of data was very large, scientists this time were also able to get a good sense of the impact of various other hormonal methods including the birth control patch, the ring, and implants as well as hormone-releasing IUDs.
The results showed it didnât much matter what sort of hormonal method was used, says Lina Morch, a research epidemiologist at the University of Copenhagen, who led the study.
Overall, Morch says, she and her colleagues found âa roughly 20 percent increased risk among women who currently use some type of hormonal contraception.â And the longer the women used hormonal methods, she says, the higher their risk.
That may sound scary. But Morch and other doctors say itâs important to consider how that additional risk translates in terms of actual cases of breast cancer. The illness is fairly rare among women in the age group studied.
âA 20 percent increase of a very small number is still a very small number,â says Mia Gaudet, an epidemiologist with the American Cancer Society. The risk contributed by hormonal contraception, she says, is similar to the extra breast cancer risk contributed by physical inactivity, excessive weight gain in adulthood, or drinking an average of one or more alcoholic drinks per day.
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Birth Control Pills And Breast Cancer
Because of the evidence linking hormone exposure to breast cancer, many epidemiological and observational studies have been conducted over the years to determine the effect of birth control pills on breast cancer risk. However, these studies do not come to the same conclusion. While the majority shows increased risk of breast cancer with the use of birth control pills, several studies also suggest no such increase.
In 1996, the first large scale meta-analysis a work of research combining results from multiple studies pooled 54 studies that involved a total of 53,297 women with breast cancer and 100,239 women without breast cancer. It showed that current and recent use of birth control pills increased the relative risk of breast cancer by up to 25% . The relative risk was higher if women started taking the pills at a younger age however, the duration of use had no effect. Nevertheless, when women had stopped taking the pills for 10 or more years, the risk returned to the same level as the ones who had never taken pills. The study included many women who took the first formulation of birth control pills, which had a very high dose of estrogen.
What To Keep In Mind When Looking At Research On Hormonal Birth Control And Cancer
There are a few important things to keep in mind when reading these results.
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Studies of older birth control pills have shown a net cancer benefit because of lowered risk of cancer of the colon, uterus and ovaries despite a raised breast cancer risk, said Mia Gaudet, a breast cancer epidemiologist at the American Cancer Society.
There was optimism that newer, low-dose contraceptives would lower the breast cancer risk, but these results have dashed those hopes, said Gaudet, who wasnt involved in the research.
About 140 million women use some type of hormonal contraception, including about 16 million in the United States.
Researchers analyzed health records of 1.8 million women, ages 15 to 49, in Denmark where a national health care system allows linking up large databases of prescription histories, cancer diagnoses and other information.
Results were published Wednesday in the New England Journal of Medicine. Novo Nordisk Foundation funded the research, but played no role in designing the study. The foundation has ties to the Danish pharmaceutical company Novo Nordisk, which primarily makes diabetes drugs and does not make contraceptives.
Current and recent use of hormonal contraceptives was associated with a 20 percent increased risk of breast cancer. Risk increased with longer use, from a 9 percent increase in risk with less than a year of contraceptive use to a 38 percent increase after more than 10 years of use.
No type of hormone contraceptive is risk-free unfortunately, said lead author Lina Morch of Copenhagen University Hospital.
Oral Contraceptives And Cancer Risk
An initial analysis of an ongoing, multicenter case-control studyindicates that women who have used oral contraceptives areapproximately half as likely to develop ovarian and endometrial canceras women who have never used them and that, despite previous concerns,contraceptive use does not appear to increase a woman’s risk of breastcancer.
The study used population-based cancer registries in eightgeographic regions across the United States to identify women 20-54years of age with newly diagnosed breast, ovarian, or endometrialcancer. Controls were women of the same ages without known cancer,chosen from the same geographic areas by dialing randomly selectedtelephone numbers.
The relative risk of ovarian cancer for women who had used oralcontraceptives for at least 1 month, as compared with women who hadnever used them, was 0.6 . The longera woman had used oral contraceptives, the lower her risk of developingovarian cancer. The protective effect of oral contraceptive usepersisted more than 10 years after pill use was discontinued.
The relative risk of ovarian cancer for women who had used oralcontraceptives for at least 1 month, as compared with women who hadnever used them, was 0.6 . The longera woman had used oral contraceptives, the lower her risk of developingovarian cancer. The protective effect of oral contraceptive usepersisted more than 10 years after pill use was discontinued.
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What If I Have A Family History Of Breast Cancer
If your mother, aunt, sibling has breast cancer, you are at higher risk of breast cancer.
If it is your grandmother and NOT mother, aunt, or sibling, then your risk is average = not higher than your person without a family history of breast cancer. However it could also be that your mother, aunt, siblings are still young and it hasnt shown up yet.
The cancer question is a risk/benefit analysis.
The Risks Of Control: Assessing The Link Between Birth Control Pills And Breast Cancer
More than 10 million women in the United States take birth control pills as a means of contraception . In 2013, more than 2.9 million American women were living with breast cancer, almost 300,000 women were diagnosed with breast cancer, and nearly 40,000 women lost their lives to breast cancer . Troublingly, many studies spanning five decades have suggested that certain kinds of birth control pills may be increasing the risk of breast cancer. So, what exactly is known about the link between birth control pills and breast cancer?
Figure 1 ~ Multiple types of birth control pills available in the market. Images from
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Birth Control And Endometrial Cancer
Use of some forms of hormonal birth control the risk of endometrial cancer.
Current users of estrogen-containing pills have half as much risk as those who never used hormonal methods . Former-users of the pill also have a reduced risk after discontinuation .
There has been less research on progestin-only birth control, but some studies have found reduced risks too. One study from 2014 found that people with heavy menstrual bleeding who used the hormonal IUD had half the risk of developing endometrial cancer . Users of the progestin-only shot have been found to be at reduced risk , and progestin-only pills might also reduce risk , though more research is needed.
Theoretically, users of progestin-only methods should be at a reduced risk, because it is thought that the synthetic progestins prevent the development of endometrial cancer .
The hormonal IUD and an oral form of the progestin found in the contraceptive shot have actually been used to treat some forms of endometrial cancer and endometrial hyperplasia, or abnormal cell growth .
Does Taking Birth Control Pills Increase My Risk Of Developing Breast Cancer
Maybe. Studies that have examined the use of oral contraceptives as a risk factor for breast cancer have produced conflicting results. Some researchers think this might be due to the fact that the level of hormones in birth control pills has changed since they were first studied. Early birth control pills contained much higher levels of hormones than today’s low-dose pills and posed a higher risk.
Scandinavian researchers have noted an increase in breast cancer in a group of women that were currently taking or had recently taken birth control pills. Longer use of the pill seemed to increase the risk. Similar research found that 10 years or more after women stopped using birth control pills, their breastcancer risk returned to the same level as if they had never used birth control pills.
However, another reputable study by Women’s Contraceptive and Reproductive Experience done between 1994 and 1998 showed there was no increased risk of breastcancer in current or former users of birth control pills.
In general, most studies have not found an overall increased risk of breast cancer due to the use of oral contraceptives.
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What Is The Contraceptive Pill
Oral contraceptives, also known as the pill, are a common form of birth control in the UK. They prevent pregnancy by changing the levels of hormones in the body. These are the hormones that control the menstrual cycle .
There are two main types:
The combined pill. This pill contains 2 hormones, oestrogen and progestogen.
The progestogen-only pill . This pill only contains the hormone progesterone.
Read more about the combined pill and the mini-pill on the NHS website. The NHS explains how they work, possible side effects and who can take each type.
What Else Affects Ovarian Cancer Risk
A womans chance of developing ovarian cancer is affected by a whole host of factors, not just the Pill and pregnancy. These include things like endometriosis, bodyweight, and smoking.
But everyones life is different, and every womans ovarian cancer risk will be influenced by a complex combination of her lifestyle and her genes. And the main cause of ovarian cancer is something none of us can control: age. Over 80 per cent of cases of the disease are in women over the age of 50 years.
The next graphic outlines some of the other factors that affect ovarian cancer risk:
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Does The Risk From Birth Control Pill Use Vary By Age
Breast cancer risk increases with age, so younger women are at lower risk of breast cancer than older women. Taking the pill while young and at low risk for breast cancer is considered relatively safe.
While studies indicate that women aged 45 and over who use the pill are nearly one-and-a-half times more likely to develop cancer, it may be due to duration of use, the fact that pills created decades earlier contained higher levels of hormones and the presence of other compounding lifestyle factors.
Should I Use The Contraceptive Pill
Your doctor can help you to make an informed choice about whether to use the pill. You should think about the risks and benefits, any health conditions you have and what you want to do.
There are many other birth control options available. These include hormonal contraceptives such as the implant, injection, and IUS . There are also contraceptives that dont contain hormones, such as the IUD . Speak to your doctor about what could work best for you.
And remember there are other things that can affect your risk of cancer more than the pill. These include smoking or not keeping a healthy weight.
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Surgeon: Abortion Birth Control Pill Linked To Breast Cancer
by APFLI | Nov 7, 2009 | Studies – Breast Cancer |
Abortion, Birth Control Pill Linked to Breast Cancer, surgeon says
Angela Lanfranchi, a clinical assistant professor of surgery at the Robert Wood Johnson Medical School in New Jersey and president of the Breast Cancer Prevention Institute labeled hormonal contraceptives a Group 1 carcinogen and said that breasts are different after an induced abortion because theyve grown and there are more places for the cancer to start. She said the same thing happens in premature delivery.
In contrast, she said, a full-term pregnancy offers protection against the disease because the mothers mammary glands have fully matured into cells capable of producing milk and most resistant to carcinogens.
Having children in the early twenties or as a teenager also decreases the breast cancer risk.
Among the other strategies for lowering breast cancer are limiting alcohol, exercising, not smoking, maintaining a normal body weight, breast-feeding your children, avoiding induced abortions, avoiding premature deliveries, and reducing exposure to estrogen.
Lanfranchi advocates natural family planning rather than birth control pills, patches or injections, which are steroidal.
For more info: www.bcpinstitute.org
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