Breast Cancer and Oral Contraception

By Ruben Obregon

October is Breast Cancer Awareness month, which is an annual campaign to build public awareness about the disease as well as to raise funds for research.

What does this educational campaign have to do with contraception? It has to do with the fact that many types of oral contraceptives contain synthetic estrogen, a steroid believed to have a  role in the development of breast cancer.[1]

Over the past two decades, multiple analyses and studies have provided convincing evidence that using oral contraceptives increases the risk of breast cancer. (See "For Further Reading" below.)   The evidence keeps mounting -- separate studies published in the January 2006 edition of  the New England Journal of Medicine,[2] the October 2006 edition of Cancer Epidemiology Biomarkers & Prevention,[3] and the October 2006 edition of Mayo Clinic Proceedings [4] confirm the increased risk.

The evidence puts contraception advocates in an awkward position of having to admit that the pill isn’t as safe as it presumed to be. Yet they cannot ignore the published evidence and maintain credibility, so they simply minimize the cancer risk by making it sound insignificant. Additionally, these advocates try to “balance” out the risk by emphasizing the fact that the pill can reduce the risk of developing endometrial and ovarian cancer.  

Oral contraceptives not only pose a risk for breast cancer, but for liver and cervical cancer as well.[5]   Considering the associated cancer risks, one has to wonder if it really is a good idea to "treat" the healthy state of fertility with know carcinogens.

“Family planning” organizations are not the only ones that find themselves in an awkward position concerning oral contraception.  The Susan G. Komen Breast Cancer Foundation, the sponsor of the “Race for the Cure©”, has given hundreds of thousands of dollars to Planned Parenthood.  Planned Parenthood routinely distributes these carcinogenic drugs to millions of women and teenage girls, something which appears to conflict with the foundation's efforts to eradicate breast cancer. 

Many in the medical community are also involved in the effort to neutralize the cancer risk oral contraceptives pose. Many physicians downplay the seriousness of contraception related breast cancer, typically citing the tendency for the cancer to not spread beyond the breast.

Even though the treatment of localized breast cancer is highly successful,  it’s not entirely curable. The five year survival rate for localized breast cancer is 98.5% for white women and 92.2% for African American women.[6]  Though typically confined to the breasts, the cancer  can still spread, significantly reducing the survival rates.

Oral contraceptives are not the only form of birth control that increases the risk of breast cancer. The World Health Organization found that Depo-Provera, an injectable contraception (which also acts as an abortifacient), also poses a breast cancer risk for users under 35. [7]

Oral contraceptives are the leading choice of contraception for women under 35, meaning that millions of women are increasing their risk of developing breast cancer. A 2003 study of young breast cancer patients revealed that oral contraception was a significant factor in breast cancer patients aged 20-35 [8] The study also revealed that the highest risk for OC use was five years prior to diagnosis.[9]

In 2002 alone, over 1.6 million women between the ages of 15-19 were using oral contraceptives [10] putting themselves at greater risk for developing cancer in their early to mid twenties.

Many of these young women are taking oral contraceptives without their parent's knowledge or consent, and at the taxpayer's expense via the Title X program. Title X is a Federal program which gives funds to “family planning” programs across the nation. Programs which receive Title X funding distribute these carcinogenic drugs to a large number of underage girls, and in most states, without parental consent.

Some would say that the cancer risk is minor, or that an insignificant amount of women will develop breast cancer as a result of using oral contraception. No case of breast cancer is insignificant, and one death from contraception related breast cancer is one death too many.

Breast cancer treatment isn’t a minor event either – it often involves removal of all or part of the breast, radiation if part of the breast is removed, and if the tumor is invasive, chemotherapy. This doesn’t sound the least bit insignificant, except to those who care more about “reproductive rights” than women’s health.

October is Breast Cancer Awareness month, a perfect time to raise awareness of the link between oral contraception and breast cancer. An excellent way to help spread the word is to email friends and family a link to this excellent publication on breast cancer and contraception, published by the Breast Cancer Prevention Institute:

If it's not OK for him to take steroids...Why is it OK for her? 

To receive No Room for Contraception updates and articles via e-mail, click [here]
 

For Further Reading: Analyses and Studies

2006 -- Meta analysis confirms increased risk for breast cancer in pre-menopausal users, especially for before first full term pregnancy (FFTP) users.  click [here] (PDF - Acrobat reader required)  Text abstract available [here]

2006 -- Study published in October 2006 confirms elevated risk with oral contraceptive use (but finds no increased risk with use by BRCA1 and BRCA2 mutation carriers).  click [here]

2006 -- Article in the New England Journal of Medicine reaffirms the oral contraceptive breast cancer link. click [here]

2005 -- WHO IARC declares combined oral estrogen-progestogen contraceptives "carcinogenic to humans" -- implicated in breast, cervix, and liver cancer.  click [here]

2003 -- National Cancer Institute Sponsored study indicates increased risk of breast cancer for women aged 20-34 who used oral contraceptives prior to diagnosis.  click [here]

2002 -- 3rd European Breast Cancer Conference presented with evidence of increased risk of breast cancer by users of oral contraceptives. click [here]

2002 -- Case control study published in the new England Journal of Medicine showed no excess risk for oral contraceptive use in women over 35.  click [here]

1996 --An analysis of studies from around the world shows that women who used contraception in the past five years had an increased risk of breast cancer.  click [here]

1980 --An analysis of 21 studies showed an increase risk in using the pill.  click [here]

Footnotes

[5] World Health Organization, Iarc Monographs Programme Finds Combined Estrogen-Progestogen Contraceptives And Menopausal Therapy Are Carcinogenic To Humans, World Health Organization Press Release N° 167, 29 July 2005, Available from http://www.iarc.fr/ENG/Press_Releases/pr167a.html

[6] American Cancer Society, Breast Cancer Facts & Figures 2005-2006. Atlanta: American Cancer Society, Inc., which cites Surveillance, Epidemiology, and End Results Program, 1973-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.

[7] Pharmacia, Depo-Provera Contraceptive Injection – Physician Information, no author listed. Available from http://www.pfizer.com/pfizer/download/uspi_depo_provera_contraceptive.pdf (Adobe PDF required)

[8] Althuis MD, Brogan DD, Coates RJ, Daling JR, Gammon MD, Malone KE, Schoenberg JB, Brinton LA., Breast cancers among very young premenopausal women. Available from http://www.springerlink.com/content/v328t6742723782w/ (purchase required)

[9] Ibid.

[10] Fertility, Family Planning, and Reproductive Health of U.S. Women: Data From the 2002 National Survey of Family Growth, Vital Statistics, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention, Series 23, No. 25 [ Page 95], Table 56. Number of women 15–44 years of age and percent distribution by current contraceptive status and method, according to age at interview: United States, 2002.

ABOUT THE AUTHOR

Ruben Obregon is the the President and co-founder of No Room for Contraception.  He has worked in the pro-family movement for the past 16 years on issues ranging from education to marriage.