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  • Title: At pill's 30th birthday, breast cancer question is unresolved.
    Author: Althaus FA, Kaeser L.
    Journal: Fam Plann Perspect; 1990; 22(4):173-6. PubMed ID: 2226748.
    Abstract:
    60 million women in the world use "the pill," (oral contraceptive (OC)); 11 million in the US alone. 30 years have passed since the pill was introduced. 2 conferences were recently held to see if oral contraceptives have bad, no, or protective effects on the development of breast cancer (BC) in women. About 9% of American women will develop BC; 150,000 new cases occur each year. The risk of developing increases with age. Major risks for BC, besides nationality, age, and race, are early menarche, childlessness, late menopause, delayed childbearing, obesity, a history of benign breast disease, and a family history of BC. The pill has been reformulated many times. Other risk factors may interact with OC use. The relative risk (RR) for ever-users has consistently been about 1.0 in more than 20 case-control studies. Risks for ever-users under 45 have pretty much been elevated, but only 1 study has found a statistically significant increase in risk for this group. Ever-users aged 30-34, and 35-39 had significantly increased relative risk of 3.2 and 2.6, respectively, compared with never-users. In 1 study, women who had used the pill for more than 15 years had an RR of 0.6. This suggests that long-term use of OCs has a protective effect. However, this was not found by a consistent pattern of decreasing risk with increasing duration of use. Among women younger than 45 years, the risk for ever-users was slightly elevated for all lengths of use in comparison with the risk for never-users. A new analysis of the Cancer and Steroid Hormone (CASH) data supports that the hypothesis that the risk of BC related to OC use may vary with age. No biological explanation exists for BC. There have been only some slight explorations of the hormonal factors that contribute to its development, so far. For years, scientist have been searching for biological "markers" that may serve as warning signs of increased risk of BC. 1 marker may be the ratio of various types of estrogens. The biggest studies analyzing the cancer-causing potential of contraceptive steroids have been on laboratory animals. However, human reproductive systems are not the same as those of animals. There is a need for further research at every level. A large case-control study is being started in June of 1990 under auspices of the National Cancer Institute. It emphasizes the rate and characteristics of OC users who develop breast cancer up to age 55. It is being done through face-to-face interviews in Seattle, New Jersey, and Atlanta.
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