A recent article in Longevity, asks, “Breast Cancer: Are The Risks Linked To Birth Control Devices?” While the Longevity article describes birth control as a blessing of modern medicine for women today, shortly after it states a sobering fact: “However, this blessing may increase the risk of breast cancer.”
This blessing can easily be reframed as a curse, and the article dives into a study that reveals devastating facts. A study conducted in Finland and published in Obstetrics & Gynecology in August 2014 found links between the use of progestogen containing IUDs and an increased risk of breast cancer. The study focused on data from 93,843 Finnish women between the ages of 30-49, who had used a progestogen-releasing IUD. The resulting database was then compared to the Finnish Cancer Registry and the results were startling.
“The risk of ductal carcinomas (the most common form of breast cancer which accounts for approximately 80% of all breast cancers as well as lobular carcinomas (which constitutes approximately 10% of all breast cancers) increased. The study states, ‘the finding of an increased standardized incidence ration for breast cancer after 5 or more years of follow-up may reflect causality between extended progestin exposure and cancer risk, but the results should be interpreted with caution in light of the limitations of the study.’”
The article does its duty in informing the audience of the facts of the study and lays out the potential risks in clear and frank language. However, one can detect the author’s tentativeness to completely condemn IUDs and other forms of hormonal birth control.
The Longevity author writes: “Any form of medical intervention carries risks and benefits which one needs to consider holistically. Does one trade-off of a small increase in breast cancer risk versus the lifestyle benefits these devices offer? This is an informed decision each woman should make for themselves in consultation with their doctor, preferably a gynecologist.”
Proper informed consent between doctor and patient is essential to patients feeling prepared for whatever risks may come from the drugs they decide to take. Unfortunately, too often women who suffer birth control side effects, including cancer, say they didn’t hear these risks mentioned by their doctor.
References
Click a subtopic below to view scientific references for each of the following cancers and their connections to birth control use.
Adams-Campbell LL, Makambi KH, Frederick WA, Gaskins M, Dewitty RL, and McCaskill-Stevens W. Breast cancer risk assessments comparing Gail and CARE models in African-American women. Breast J. 15 Suppl 2009; 1:S72–75.
Amadou A, Fabre A, Torres-Mejía G, Ortega-Olvera C, Angeles-Llerenas A, McKenzie F, Biessy C, Hainaut P, and Romieu I. Hormonal therapy and risk of breast cancer in Mexican women. PLoS One 2013; 8:e79695.
Beaber EF, Buist DS, Barlow WE, Malone KE, Reed SD, and Li CI. Recent oral contraceptive use by formulation and breast cancer risk among women 20 to 49 years of age. Cancer Res 2014a; 74:4078–4089.
Beaber EF, Malone KE, Tang MT, Barlow WE, Porter PL, Daling JR, and Li CI. Oral contraceptives and breast cancer risk overall and by molecular subtype among young women. Cancer Epidemiol Biomarkers Prev 2014b; 23:755–764.
Beji NK and Reis N. Risk factors for breast cancer in Turkish women: a hospital-based case-control study. Eur J Cancer Care (Engl). 2007; 16:178–184.
Bethea TN, Rosenberg L, Hong CC, Troester MA, Lunetta KL, Bandera EV, Schedin P, Kolonel LN, Olshan AF, Ambrosone CB, and Palmer JR. A case-control analysis of oral contraceptive use and breast cancer subtypes in the African American Breast Cancer Epidemiology and Risk Consortium. Breast Cancer Res 2015; 17:22. Doi:10.1186/s13058-015-0535-x.
Brohet RM, Goldgar DE, Easton DF, Antoniou AC, Andrieu N, Chang-Claude J, Peock S, Eeles RA, Cook M, Chu C, Noguès C, Lasset C, Berthet P, Meijers-Heijboer H, Gerdes AM, Olsson H, Caldes T, van Leeuwen FE, and Rookus MA. Oral contraceptives and breast cancer risk in the international BRCA1/2 carrier cohort study: a report from EMBRACE, GENEPSO, GEO-HEBON, and the IBCCS Collaborating Group. J Clin Oncol 2007; 25:3831–3836.
Delort L, Kwiatkowski F, Chalabi N, Satih S, Bignon YJ, and Bernard-Gallon DJ. Risk factors for early age at breast cancer onset—the “COSA program” population-based study. Anticancer Res 2007; 27:1087–1094.
Dolle JM, Daling JR, White E, Brinton LA, Doody DR, Porter PL, and Malone KE. Risk factors for triple-negative breast cancer in women under the age of 45 years. Cancer Epidemiol Biomarkers Prev 2009; 18:1157–1166.
Figueiredo JC, Haile RW, Bernstein L, Malone KE, Largent J, Langholz B, Lynch CF, Bertelsen L, Capanu M, Concannon P, Borg A, Børresen-Dale AL, Diep A, Teraoka S, Torngren T, Xue S, and Bernstein JL. Oral contraceptives and postmenopausal hormones and risk of contralateral breast cancer among BRCA1 and BRCA2 mutation carriers and noncarriers: the WECARE Study. Breast Cancer Res Treat 2010; 120:175–183.
Folger SG, Marchbanks PA, McDonald JA, Bernstein L, Ursin G, Berlin JA, Daling JR, Norman SA, Strom BL, Weiss LK, Simon MS, Burkman RT, Malone KE, and Spirtas R. Risk of breast cancer associated with short-term use of oral contraceptives. Cancer Causes Control 2007; 18:189–198.
Friebel TM, Domchek SM, and Rebbeck TR. Modifiers of cancer risk in BRCA1 and BRCA2 mutation carriers: systematic review and meta-analysis. J Natl Cancer Inst 2014; 106(6):dju091. Doi: 10.1093/jnci/dju091.
Haile RW, Thomas DC, McGuire V, Felberg A, John EM, Milne RL, Hopper JL, Jenkins MA, Levine AJ, Daly MM, Buys SS, Senie RT, Andrulis IL, Knight JA, Godwin AK, Southey M, McCredie MR, Giles GG, Andrews L, Tucker K, Miron A, Apicella C, Tesoriero A, Bane A, Pike MC; kConFab Investigators; Ontario Cancer Genetics Network Investigators, and Whittemore AS. BRCA1 and BRCA2 mutation carriers, oral contraceptive use, and breast cancer before age 50. Cancer Epidemiol Biomarkers Prev 2006; 15:1863–1870.
Heikkinen S, Koskenvuo M, Malila N, Sarkeala T, Pukkala E, and Pitkäniemi J. Use of exogenous hormones and the risk of breast cancer: results from self-reported survey data with validity assessment. Cancer Causes Control 2016; 27:249–258.
Hunter DJ, Colditz GA, Hankinson SE, Malspeis S, Spiegelman D, Chen W, Stampfer MJ, and Willett WC. Oral contraceptive use and breast cancer: a prospective study of young women. Cancer Epidemiol Biomarkers Prev 2010; 19:2496–2502.
Ichida M, Kataoka A, Tsushima R, and Taguchi T. No increase in breast cancer risk in Japanese women taking oral contraceptives: a case-control study investigating reproductive, menstrual and familial risk factors for breast cancer. Asian Pac J Cancer Prev 2015; 16:3685–3690.
Jernström H, Loman N, Johannsson OT, Borg A, and Olsson H. Impact of teenage oral contraceptive use in a population-based series of early-onset breast cancer cases who have undergone BRCA mutation testing. Eur J Cancer 2005; 41:2312–2320.
Kahlenborn C, Modugno F, Potter DM, and Severs WB. Oral Contraceptive Use as a Risk Factor for Premenopausal Breast Cancer: A Meta-analysis. Mayo Clin Proc 2006; 81:1290–1302.
Kotsopoulos J, Lubinski J, Moller P, Lynch HT, Singer CF, Eng C, Neuhausen SL, Karlan B, Kim-Sing C, Huzarski T, Gronwald J, McCuaig J, Senter L, Tung N, Ghadirian P, Eisen A, Gilchrist D, Blum JL, Zakalik D, Pal T, Sun P, and Narod SA; Hereditary Breast Cancer Clinical Study Group. Timing of oral contraceptive use and the risk of breast cancer in BRCA1 mutation carriers. Breast Cancer Res Treat 2014; 143:579–586.
Lee E, Ma H, McKean-Cowdin R, Van Den Berg D, Bernstein L, Henderson BE, and Ursin G. Effect of reproductive factors and oral contraceptives on breast cancer risk in BRCA1/2 mutation carriers and noncarriers: results from a population-based study. Cancer Epidemiol Biomarkers Prev 2008; 17:3170–3178.
Li CI, Beaber EF, Tang MT, Porter PL, Daling JR, and Malone KE. Effect of depo-medroxyprogesterone acetate on breast cancer risk among women 20 to 44 years of age. Cancer Res 2012; 72:2028–2035.
Lumachi F, Frigo AC, Basso U, Tombolan V, and Ermani M. Estrogen therapy and risk of breast cancer in postmenopausal women: a case-control study and results of a multivariate analysis. Menopause 2010; 17:524–528.
Lund E, Bakken K, Dumeaux V, Andersen V, and Kumle M. Hormone replacement therapy and breast cancer in former users of oral contraceptives–The Norwegian Women and Cancer study. Int J Cancer 2007; 121:645–648.
Ma H, Bernstein L, Ross RK, and Ursin G. Hormone-related risk factors for breast cancer in women under age 50 years by estrogen and progesterone receptor status: results from a case-control and a case-case comparison. Breast Cancer Res 2006; 8:R39.
Ma H, Wang Y, Sullivan-Halley J, Weiss L, Marchbanks PA, Spirtas R, Ursin G, Burkman RT, Simon MS, Malone KE, Strom BL, McDonald JA, Press MF, and Bernstein L. Use of four biomarkers to evaluate the risk of breast cancer subtypes in the women’s contraceptive and reproductive experiences study. Cancer Res 2010; 70:575–587.
Mehrgou A and Akouchekian M. The importance of BRCA1 and BRCA2 genes mutations in breast cancer development. Med J Islam Repub Iran 2016; 30:369.
Milne RL, Knight JA, John EM, Dite GS, Balbuena R, Ziogas A, Andrulis IL, West DW, Li FP, Southey MC, Giles GG, McCredie MR, Hopper JL, and Whittemore AS. Oral contraceptive use and risk of early-onset breast cancer in carriers and noncarriers of BRCA1 and BRCA2 mutations. Cancer Epidemiol Biomarkers Prev 2005; 14:350–356.
Moorman PG, Havrilesky LJ, Gierisch JM, Coeytaux RR, Lowery WJ, Peragallo Urrutia R, Dinan M, McBroom AJ, Hasselblad V, Sanders GD, and Myers ER. Oral contraceptives and risk of ovarian cancer and breast cancer among high-risk women: a systematic review and meta-analysis. J Clin Oncol 2013;31(33): 4188–4198. Doi:10.1200/JCO.2013.48.9021.
Mørch LS, Skovlund CW, Hannaford PC, Iversen L, Fielding S, and Lidegaard Ø. Contemporary hormonal contraception and the risk of breast cancer. N Engl J Med 2017; 377:2228–2239.
Ozmen V, Ozcinar B, Karanlik H, Cabioglu N, Tukenmez M, Disci R, Ozmen T, Igci A, Muslumanoglu M, Kecer M,and Soran A. Breast cancer risk factors in Turkish women—a University Hospital based nested case control study. World J Surg Oncol 2009; 7:37.
Parkin DM. Cancers attributable to exposure to hormones in the UK in 2010. British Journal of Cancer 2011; 105: S42–S48.
Phipps AI, Chlebowski RT, Prentice R, McTiernan A, Wactawski-Wende J, Kuller LH, Adams-Campbell LL, Lane D, Stefanick ML, Vitolins M, Kabat GC, Rohan TE, and Li CI. Reproductive history and oral contraceptive use in relation to risk of triple-negative breast cancer. J Natl Cancer Inst 2011; 103:470–477.
Poosari A, Promthet S, Kamsa-ard S, Suwanrungruang K, Longkul J, and Wiangnon S. Hormonal contraceptive use and breast cancer in Thai women. J Epidemiol 2014; 24:216–220.
Rosenberg L, Zhang Y, Coogan PF, Strom BL, and Palmer JR. A case-control study of oral contraceptive use and incident breast cancer. Am J Epidemiol 2008; 169:473–479.
Rosenberg L, Boggs DA, Wise LA, Adams-Campbell LL, and Palmer JR. Oral contraceptive use and estrogen/progesterone receptor-negative breast cancer among African American women. Cancer Epidemiol Biomarkers Prev 2010; 19:2073–2079.
Samson ME, Adams SA, Mulatya CM, Zhang J, Bennett CL, Hebert J, and Steck SE. Types of oral contraceptives and breast cancer survival among women enrolled in Medicaid: A competing-risk model. Maturitas 2017; 95:42–49.
Silvera SA, Miller AB, and Rohan TE. Oral contraceptive use and risk of breast cancer among women with a family history of breast cancer: a prospective cohort study. Cancer Causes Control. 2005; 16:1059–1063.
Soini T, Hurskainen R, Grénman S, Mäenpää J, Paavonen J, and Pukkala E. Cancer risk in women using the levonorgestrel-releasing intrauterine system in Finland. Obstet Gynecol 2014; 124 (2 Pt 1): 292–299.
Sweeney C, Giuliano AR, Baumgartner KB, Byers T, Herrick JS, Edwards SL, and Slattery ML. Oral, injected and implanted contraceptives and breast cancer risk among U.S. Hispanic and non-Hispanic white women. Int J Cancer 2007; 121:2517–2523.
Thorbjarnardottir T, Olafsdottir EJ, Valdimarsdottir UA, Olafsson O, and Tryggvadottir L. Oral contraceptives, hormone replacement therapy and breast cancer risk: a cohort study of 16 928 women 48 years and older. Acta Oncol 2014; 53:752–758.
Trivers KF, Gammon MD, Abrahamson PE, Lund MJ, Flagg EW, Moorman PG, Kaufman JS, Cai J, Porter PL, Brinton LA, Eley JW, and Coates RJ. Oral contraceptives and survival in breast cancer patients aged 20 to 54 years. Cancer Epidemiol Biomarkers Prev 2007; 16:1822–1827.
Veisy A, Lotfinejad S, Salehi K, and Zhian F. Risk of breast cancer in relation to reproductive factors in North-West of Iran, 2013-2014. Asian Pac J Cancer Prev 2015; 16:451–455.
Veneroso C, Siegel R, and Levine PH. Early age at first childbirth associated with advanced tumor grade in breast cancer. Cancer Detect Prev 2008; 32:215–223.
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies. PLoS Medicine 2007; 4:1623–27 (e296). Doi: 10.1371/journal.pmed. 0040296.
Williams WV, Carlson K, Mitchell LA, and Raviele K. Association of Combined Estrogen-Progestogen and Progestogen Only Contraceptives with the Development of Cancer. The Linacre Quarterly 2018; 85(4): 412–452.
World Health Organization International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risk to Humans. Combined Estrogen−Progestogen Contraceptives and Combined Estrogen−Progestogen Menopausal Therapy. 2007; http://monographs.iarc.fr/ENG/Monographs/vol91/mono91.pdf.
World Health Organization International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risk to Humans. Combined Estrogen−Progestogen Contraceptives. IARC Monographs 2012; 100A:283–318; http://monographs.iarc.fr/ENG/Monographs/vol100A/mono100A-19.pdf.
Yager JD and Davidson NE. Estrogen Carcinogenesis in Breast Cancer. N Engl J Med 2006; 354:270-282.
[50] Zhu H, Lei X, Feng J, and Wang Y. Oral contraceptive use and risk of breast cancer: a meta-analysis of prospective cohort studies. Eur J Contracept Reprod Health Care 2012; 17:402–414.
World Health Organization International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risk to Humans. Combined Estrogen−Progestogen Contraceptives and Combined Estrogen−Progestogen Menopausal Therapy. 2007;
http://monographs.iarc.fr/ENG/Monographs/vol91/mono91.pdf.
World Health Organization International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risk to Humans. Combined Estrogen−Progestogen Contraceptives. IARC Monographs 2012; 100A:283–318; http://monographs.iarc.fr/ENG/Monographs/vol100A/mono100A-19.pdf.
International Collaboration of Epidemiological Studies of Cervical Cancer, Appleby P, Beral V, Berrington de González A, Colin D, Franceschi S, Goodhill A, Green J, Peto J, Plummer M, and Sweetland S. Cervical cancer and hormonal contraceptives: collaborative reanalysis of individual data for 16,573 women with cervical cancer and 35,509 women without cervical cancer from 24 epidemiological studies. Lancet 2007; 370:1609–1621.
Leslie HH, Karasek DA, Harris LF, Chang E, Abdulrahim N, Maloba M, and Huchko MJ. Cervical cancer precursors and hormonal contraceptive use in HIV-positive women: application of a causal model and semiparametric estimation methods. PLoS One 2014; 9:e101090.
Matos A, Moutinho J, Pinto D, and Medeiros R. The influence of smoking and other cofactors on the time to onset to cervical cancer in a southern European population. Eur J Cancer Prev 2005; 14:485–491.
McFarlane-Anderson N, Bazuaye PE, Jackson MD, Smikle M, and Fletcher HM. Cervical dysplasia and cancer and the use of hormonal contraceptives in Jamaican women. BMC Womens Health 2008; 8:9.
Moreno V, Bosch FX, Muñoz N, Meijer CJ, Shah KV, Walboomers JM, Herrero R, Franceschi S; International Agency for Research on Cancer. Multicentric Cervical Cancer Study Group. Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection: the IARC multicentric case-control study. Lancet 2002; 359(9312):1085–1092.
Roura E, Travier N, Waterboer T, de Sanjosé S, Bosch FX, Pawlita M, Pala V, Weiderpass E, Margall N, Dillner J, Gram IT, Tjønneland A, Munk C, Palli D, Khaw KT, Overvad K, Clavel-Chapelon F, Mesrine S, Fournier A, Fortner RT, Ose J, Steffen A, Trichopoulou A, Lagiou P, Orfanos P, Masala G, Tumino R, Sacerdote C, Polidoro S, Mattiello A, Lund E, Peeters PH, Bueno-de-Mesquita HB, Quirós JR, Sánchez MJ, Navarro C, Barricarte A, Larrañaga N, Ekström J, Lindquist D, Idahl A, Travis RC, Merritt MA, Gunter MJ, Rinaldi S, Tommasino M, Franceschi S, Riboli E, and Castellsagué X. The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort. PLoS One 2016; 11:e0147029.
Vanakankovit N and Taneepanichskul S. Effect of oral contraceptives on risk of cervical cancer. J Med Assoc Thai 2008; 91:7–12.
Wilson JC, O’Rorke MA, Cooper JA, Murray LJ, Hughes CM, Gormley GJ, and Anderson LA. Non-steroidal anti-inflammatory drug use and cervical cancer risk: a case-control study using the Clinical Practice Research Datalink. Cancer Epidemiol 2013; 37:897–904.
For more information on the link between cancer risks and birth control use, see the articles below.