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Study Suggests Recent Use of Some Birth Control Pills May Be Associated With Increased Breast Cancer Risk

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Key Points

  • In a nested case-control study, investigators found that recent oral contraceptive use increased breast cancer risk by 50%, compared with never or former use.
  • The risk varied by oral contraceptive formulation, and birth control pills containing low-dose estrogen did not increase breast cancer risk.
  • The investigators noted that the results require confirmation and should be interpreted with caution.
  • Prior studies have suggested that the increased risk associated with recent oral contraceptive use declines after stopping oral contraceptives.

Women who recently used birth control pills containing high-dose estrogen and a few other formulations had an increased risk for breast cancer, whereas women using some other formulations did not, according to data published in Cancer Research.

“Our results suggest that use of contemporary oral contraceptives in the past year is associated with an increased breast cancer risk relative to never or former oral contraceptive use, and that this risk may vary by oral contraceptive formulation,” said Elisabeth F. Beaber, PhD, MPH, a staff scientist in the Public Health Sciences Division of Fred Hutchinson Cancer Research Center in Seattle, Washington.

“Our results require confirmation and should be interpreted cautiously,” added Dr. Beaber. “Breast cancer is rare among young women and there are numerous established health benefits associated with oral contraceptive use that must be considered. In addition, prior studies suggest that the increased risk associated with recent oral contraceptive use declines after stopping oral contraceptives.”

Study Details

In a nested case-control study of 1,102 women diagnosed with breast cancer and 21,952 controls, Dr. Beaber and colleagues found that recent oral contraceptive use increased breast cancer risk by 50%, compared with never or former use. All study participants were at Group Health Cooperative in the Seattle-Puget Sound area. Patients received a cancer diagnosis between 1990 and 2009.

Birth control pills containing high-dose estrogen increased breast cancer risk 2.7-fold, and those containing moderate-dose estrogen increased the risk 1.6-fold. Pills containing ethynodiol diacetate increased the risk 2.6-fold, and triphasic combination pills containing an average of 0.75 mg of norethindrone increased the risk 3.1-fold.

Birth control pills containing low-dose estrogen did not increase breast cancer risk.

About 24%, 78%, and less than 1% of study controls who were recent oral contraceptive users filled at least one prescription in the past year for low-, moderate-, and/or high-estrogen dose oral contraceptives, respectively, according to Dr. Beaber.

Unlike most previous studies that depended on women’s self-report or recall, which may cause bias, the investigators used electronic pharmacy records to gather detailed information on oral contraceptive use including drug name, dosage, and duration of medication.

Dr. Beaber is the corresponding author for the Cancer Research article.

This study was funded by the National Cancer Institute. Dr. Beaber declared no conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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