Jewish World Review June 27, 2002 / 17 Tamuz, 5762

'The pill' not linked to breast cancer

By Katrina Woznicki | (UPI) Middle-aged women's worries about a connection between breast cancer and oral contraceptives should be eased by a new study that shows no association with increased risk of developing the illness, researchers reported Wednesday.

The study, involving two federal agencies and several medical centers around the United States, examined the possible effects of previous birth control pill use among women ages 35 to 64. Some of the women were the first to use oral contraceptives when "the pill" became available in 1960. These first generation contraceptives have long been suspected of association with breast cancer risk because they contained higher dosages of estrogen and progestin than current birth control pills.

Researchers working with the National Institute of Child Health and Human Development in Bethesda, Md., and at the Centers for Disease Control in Atlanta interviewed more than 9,200 Caucasian and African-American women living in Detroit, Seattle, Wash., Philadelphia, Los Angeles and Atlanta. Approximately half of the women were recently diagnosed with breast cancer. All of the participants were asked about their past use of oral contraceptives or any other hormones. They also were asked questions about reproductive health and medical history. This data was collected from 1994 to 1998.

Compared to women who never took birth control pills, the study subjects who took some type of oral contraceptive were found to be at no greater risk for breast cancer. Even after researchers took into account such factors as current or former oral contraceptive use, duration of prior use, age at first use and how much time had passed since last use, there still was no difference.

"I think our study has many strengths," lead study author Polly Marchbanks of the CDC told United Press International. "Our study provides strong evidence that past use of oral contraceptives doesn't increase the risk of breast cancer later in life. This is an especially crucial issue because of the high prevalence of breast cancer and the widespread use of oral contraceptives."

Marchbanks added, "For most healthy women who do not smoke, the health benefits of oral contraceptives far exceed the health risks and this study provides reassurance."

Researchers also found women with a family history of breast cancer who took oral contraceptives did not face significantly increased risk of developing the disease. Going on the pill at a young age also proved not to be a risk factor for breast cancer. The results were seen across the board among various age and racial groups, the study said.

The study, "Women's Contraceptive and Reproductive Experiences," or "Women's CARE," is published in the June 27 issue of The New England Journal of Medicine.

In an accompanying editorial, Drs. Kathy Helzlsouer and Nancy Davidson of the Johns Hopkins Medical Institutions in Baltimore wrote the study is a solid work that should put women's concerns to rest and reverse the notion the pill somehow causes breast cancer.

"It's a very good study and it's a good look at an area that still had some controversy," Helzlsouer told UPI. "It would be great if at the same time (oral contraceptives) could lower the risk of breast cancer. That would be ideal."

Numerous scientific studies have affirmed oral contraceptive use reduces the risk of uterine and ovarian cancers. Scientists have questioned whether tinkering with the pill formulations would make it possible to create a birth control pill that could actually help prevent breast cancer.

The concern over whether the pill causes breast cancer flared up after a 1996 review of 54 studies spanning 25 years suggested a slight increased risk for current and recent users of oral contraceptives. Several subsequent studies have found no such link, however, and oncologists, obstetricians and gynecologists agree the evidence just isn't there to support a connection.

Ruth Heimann, a breast cancer oncologist and professor in the department of radiation and cellular oncology at the University of Chicago, told UPI the study is "consistent with what's generally been the impression. Every additional one reinforces," the notion the pill does not cause breast cancer, Heimann added, "and I hope it (the study) will put it to rest."

Anita Nelson, professor of obstetrics and gynecology at the University of California at Los Angeles in Los Angeles, Calif. agreed.

"There is this high concept that breast cancer is estrogen sensitive" when it comes to oral contraceptives, Nelson said, "but every time we look at the pill ... there is no increased risk of breast cancer. We never thought the pill increased risk beyond age 45 anyway."

Such findings might "sound like it's repetitious," Nelson added, "but it is so important to gain the confidence of women."

Current figures show about 180,000 American women per year are diagnosed with breast cancer and about 45,000 die from the disease, though Heimann said the mortality rate has been declining by a few percentage points each year.

Heimann said women mistakenly overestimate their breast cancer risk. "Cancer has this stigma or this aura of something terrible and I think that perception to some extent remains," she said. In contrast, heart disease, the number one killer of American women, affects a half million women every year. Heart disease, Heimann said, cannot be cured, but managed. "Cancer, you remove it, you treat, and it's curable."

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© 2002, United Press International