Birth control pill risks needn't alarm, docs say

Report eyes potential offset to breast cancer dangers from contraceptives with hormones

Although women using modern-day hormonal contraceptives may be increasing their risk of breast cancer somewhat, the pill's protective qualities may offset that danger.

That conclusion, according to a recent story by Roni Caryn Rabin in The New York Times, comes from many doctors who prescribe contraceptives and claim "there's no cause for alarm — and no one should throw away her pills and risk an unwanted pregnancy."

Rabin's piece followed by only a few days her own story about a Danish study indicating that heightened risks — though small — still exist despite the lower estrogen content of newer pills and IUDs.

She'd initially cited a British study of more than 46,000 women "who were recruited in 1968, during the early days of the pill, and followed for up to 44 years," but has now walked back her position and quoted another study to the effect that "despite increases in breast and cervical cancers among those who used the pill, the effect on overall cancer rates was neutral because other cancers were reduced."  

Other studies, Rabin maintained, "have reached the same conclusion."

David J. Hunter

David J. Hunter, epidemiology and medicine prof at the University of Oxford in Britain, is quoted in her newer Times story as indicating contraceptive use might prevent more cancers "in aggregate, over a woman's lifetime" than it causes.

Hunter's comments were made in a commentary published in The New England Journal of Medicine. 

First among Rabin's suggestions for what women are to do with the new information is "to speak with your health care [provider, think] about your priorities and preferences, the stage of life you're in, your family plans and medical history, and find a doctor who will take time to listen to your concerns."

She then quotes Dr. Christine Dehlendorf, director of the program in women-centered contraception in the department of family and community medicine at the University of California, San Francisco, as saying, "We have to trust women to know what their preferences are, and what their abilities are to use certain methods, and to choose the methods that are the best choice for them."

More information on studies detailing risks of the disease can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Contraceptive pills, IUDs endanger women

Modern birth control methods hike breast cancer risk just like older ones, study finds

Newer birth control methods that release hormones can raise women's risk for breast cancer — just as the older ones did.

That's the conclusion of a new study recently reported by Ronnie Caryn Rabin in The New York Times.

The findings, based on following nearly 1.8 million Danish women of childbearing age for more than a decade, corroborates conventional wisdom that birth control pills and IUDs can be problematic despite the added risk being small.

The Times piece indicates the study, published in the New England Journal of Medicine, "upends widely held assumptions about modern contraceptives for younger generations of women," many of whom have believed that the newer contraceptives "are much safer than those taken by their mothers or grandmothers, which had higher doses of estrogen."

According to Rabin's story, "the research also suggests that the hormone progestin — widely used in today's birth control methods — may be raising breast cancer risk."

Dr. Marisa Weiss

The Times piece quotes Dr. Marisa Weiss, an oncologist who founded the breastcancer.org website but who was not involved in the study, as believing the research is important "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. Gynecologists just assumed that a lower dose of hormone meant a lower risk of cancer. But the same elevated risk is there."

The findings show "a significant public health concern," she says — even though, according to the Times, the study failed to "take into account factors like physical activity, breast feeding and alcohol consumption, which may also influence breast cancer risk."

Officials at the American College of Obstetricians and Gynecologists plan to evaluate the new findings but, the Times says, still emphasized that hormonal contraceptives are for many women "among the most safe, effective and accessible options available."

Weiss, however, suggested in Rabin's story that, because risk increases with age, "older women may want to consider switching to a hormone-free birth control method, like a diaphragm, an IUD that does not release hormones, or condoms. 'It's not like you don't have a choice,' she said. 'Why not pursue another option?'"

Rabin also quoted Lina Steinrud Mørch, Ph.D., the study's lead author and a senior researcher at the University of Copenhagen, to the effect that the findings — which also showed "the risk increased the longer women used contraceptives, suggesting the relationship is causal" — presented "a very clear picture…very convincing."

According to Mørch, "among those who used hormones for five years, an increased breast cancer risk persisted even after they discontinued use."

And women who stayed on hormones 10 years or more experienced a jump in risk of 38 percent.

Since researchers originally had expected to find "a smaller increase in risk because today we have lower doses of estrogen in the hormone contraceptives," says Mørch, "it was surprising that we found [the] association."

The study concluded that although "hormone users over all experienced a 20 percent increase in the relative risk of breast cancer compared to nonusers…the additional risk would result in comparatively few additional cases of breast cancer." 

More information on risk factors for the disease can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.