Maybe women using hormones are in more routine contact with health professionals and thus are more likely to be diagnosed a little earlier,” Westhoff said. For one, studies have shown that women who are on contraceptives tend to be diagnosed at earlier stages if they get cancer. So far, neither this study nor any others have answered that question, leaving Westhoff with some reservations. That’s what’s fascinating - they’re all so different, but end up with the same relative risk,” Westhoff said. ![]() “Their dose and biological effects are quite different. All of the various hormonal contraceptives are vastly different from one another. The study also raises a bit of a biological puzzle. I think some people might be upset with this paper because they thought they would get away from that risk with the IUD,” she said. “It’s going to be surprising to people that the IUD is associated with the same risk. That may make the decision to use hormonal contraception a little bit more complicated for people who are concerned about an already elevated breast cancer risk. The study throws into question the assumption that more local applications of progestin like IUDs might be less likely to contribute to breast cancer risk, Westhoff said. For these individuals, a 20% to 30% increase in cancer risk may translate to higher absolute odds of getting breast cancer, although Reeves cautioned that there’s less research done specifically on groups of women with high-risk mutations and hormonal contraceptives. The exception may be for people who already have an elevated risk of breast cancer due to certain pathogenic mutations or a family history of breast cancer. “So, the modern, newer forms of hormonal contraceptives behave pretty much the same as we’ve been using for decades.” So, 20 to 30% of something that’s very small is still very small,” Reeves added. “We’re talking about a risk that acts on women in their 20s and 30s, when we have a very low background risk. In absolute terms, also as in past studies, that translates to an absolute increase of about half a percent for women under the age of 50. “That was a combined oral, progestin only injection, IUD, whatever,” Reeves said. Reeves found that women who took any kind of hormonal contraceptive also had a relative increased risk of breast cancer of about 20% to 30% while they were on it. Then, they matched those cases with women who did not have cancer at a similar age and same general practice clinic and compared their prescription histories for contraceptives. To do the study, they gathered data from a large primary care database in the United Kingdom called the Clinical Practice Research Datalink and analyzed all breast cancer cases between 19. ![]() So, Reeves and her colleagues wanted to see if any of the modern hormonal birth control offerings made any difference in breast cancer risk. ![]() “After that 1996 study, we didn’t know much about the effects of other kinds of contraceptives,” Reeves said. Today, progestin-only options like the minipill or the intrauterine device proliferate. The issue is that in the 1990s, the combination pill containing both estrogen and progestin was the main oral contraceptive. These hormones are also important to the formation and growth of the majority of breast cancers, so researchers have studied how hormonal birth control might alter one’s breast cancer risk. Hormonal birth control can contain estrogen and progestin or progestin alone and work by preventing the release of eggs from the ovaries, thickening cervical mucus, and thinning the endometrium. “It’s kind of interesting and strange that all of these different hormonal contraceptives with or without estrogen have an increased risk so close to each other,” said Carolyn Westhoff, an obstetrician and contraceptives researcher at Columbia University who did not work on the study. The analysis found that most forms of hormonal birth control, regardless of their formulation, seem to confer roughly the same, small increase to breast cancer risk. One might think, then, that they may have an unequal influence on breast cancer risk, but a new study in PLOS Medicine on Tuesday suggests that’s not so. Pills, patches, implants, and injections - the various forms of hormonal birth control have different formulations and doses of estrogen, progestin, or both.
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