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

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Whether it's the pill, the patch, or a range of other products, millions of women today use hormonal contraceptives; so it's little surprise that a new study shows that those who take them have an increased risk of breast cancer.

For now, Morch said, even with the newer pharmaceuticals, women whose families have a strong history of breast cancer or heart disease may want to consider using other methods of birth control, such as employing condoms or spermicidal devices.

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.

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

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.

"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.

"The increased risk also with newer progestins in hormonal contraceptives has not been shown consistently before, though progestins in postmenopausal therapy has also been found to increase the risk of breast cancer", she added. The researchers tracked almost 1.8 million women starting in 1995 and compared those who purchased birth control methods with women who developed breast cancer. The link with cancer risk exists not only for older generations of hormonal contraceptives but also for the products that many women use today, according to a paper published Wednesday in the New England Journal of Medicine.

"This is an important study because we had no idea how the modern day pills compared to the old-fashioned pills in terms of breast cancer risk, and we didn't know anything about IUDs", Dr. Marisa Weiss, an oncologist who founded the website breastcancer.org and was not involved in the study told The New York Times. "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".

Two types of birth control pills are sold in the USA - one that combines synthetic versions of the hormones estrogen and progesterone, and the "minipill" that only delivers progestin, a synthetic formulation of progesterone.

"The relative risk increase in this study is only 1.2 on average. However, the risk also with newer progestins was more consistent and convincing than expected, in particular the increased risk with hormone IUD (includes only progestin)". 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. Any woman's risk of breast cancer goes up as she gets older.

"No one should take (oral contraceptives) without careful thought, but the advantages in avoiding an unwanted pregnancy will usually more than outweigh the very slightly increased risk of breast cancer", said Ashley Grossman, emeritus professor of endocrinologyat Britain's University of Oxford.

Beyond the fact that they provide an effective means of contraception and may benefit women with menstrual cramping or abnormal menstrual bleeding, "the use of oral contraceptives is associated with substantial reductions in the risks of ovarian, endometrial, and colorectal cancers later in life".

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