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OCs Do Not Increase Risk for Breast Cancer

Oral contraceptive use did not change risk for breast cancer among women with traditional risk factors, such as family history or delayed menopause.

The relation between oral contraceptive (OC) use and breast cancer is controversial. To determine risk for breast cancer among former and current OC users, investigators interviewed 4575 women (age range, 35 to 64) with breast cancer (diagnosed between 1994 and 1998) and 4682 controls (identified by random-digit dialing) in 5 U.S. cities.

Sixty-five percent of the women were white, and 35% were black. Compared with controls, women with cancer had traditional risk factors (e.g., were older at first-term pregnancy and at menopause, had family histories of breast cancer). Overall, 77% of cases and 79% of controls had used OCs. Compared with women who never had used OCs, ever users and current users were not at increased risk for breast cancer (odds ratios, 0.9 and 1.0, respectively). Relative risk did not increase with duration of use (to 15 years), higher estrogen doses, or younger age at first use. Risks were similar in white and black women. OC use by women with family histories of breast cancer did not increase risk.

Comment: Data from this large study should be reassuring to OC users and to their physicians. The validity of the findings is supported by the fact that recognized risk factors for breast cancer were more common in women with breast cancer than in controls. An editorialist notes that additional studies are needed to determine the risk associated with current OC use by women in their 40s -- a common practice for management of perimenopausal symptoms.

— Robert W Rebar, MD

Published in Journal Watch General Medicine July 5, 2002

Citation(s):

Marchbanks PA et al. Oral contraceptives and the risk of breast cancer. N Engl J Med 2002 Jun 27; 346:2025-32.

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Davidson NE and Helzlsouer KJ. Good news about oral contraceptives. N Engl J Med 2002 Jun 27; 346:2078-9.

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• Medline abstract (Free)