Breast cancer: is the Pill a threat?

Latest research
Research recently completed in Canada has shown that some women are more at risk of developing breast cancer if they have used the contraceptive pill for five or more years.

The study, which was undertaken by the Centre for Research in Women's Health and the Women's College Health Sciences Centre at the University of Toronto, examined the medical history and oral contraceptive use of 1,311 pairs of women known to carry certain types of gene mutation.

The gene mutations apparently occur in women with a strong family history of breast cancer – women with one relative under 40 years of age who has had breast cancer, two under 60, or three of any age on the same side of a family who have suffered from the disease.

The research found that women with the BRCA1 gene mutation and who have used oral contraceptives for five or more years have a 33 per cent increased risk of early onset of breast cancer, compared to women who have never used birth control pills.

Dr Steven Narod and his team who carried out the research also found elevated risk levels for women who used birth control pills before the age of 30 and women who first used the pill before 1975.

Qualified risks
The researchers were careful to point out that their findings do not mean that all women who take the contraceptive pill are at a great risk of developing breast cancer.

In his report, Dr Narod stated firmly, 'The findings…are relevant only to women who carry BRCA1 and BRCA2 gene mutations. In general the pill does not appear to increase the risk of breast cancer in the wider population.'

In the UK, it is estimated that between 5 and 10 per cent of the 39,000 breast cancers diagnosed each year are due to strong hereditary factors. Of these, BRCA1 and BRCA2 account for around 80 per cent, with the former being the more common.

At first glance, the report appears to pose a dilemma for women under 30 who may wish to take the contraceptive pill. But Bernie Gardiner, an information nurse specialist with Breast Cancer Care, says, 'It is important that family history is taken into consideration when prescribing the Pill so that an informed decision can be made.'

Delyth Morgan, chief executive of Breakthrough Breast Cancer, supports this view, adding that the research provides important information for women with a strong family history of breast cancer.

'[They] can be given clear advice about the pros and cons of taking the Pill in relation to their own risk of developing the disease,' she says.

Confusing messages
Dr Richard Sullivan, head of clinical programmes at Cancer Research UK, says he sympathises with women in the light of this report. 'There are so many messages coming out from different sources that it is very confusing for women to know what they should be concerned about,' he says.

'However, it must be borne in mind that hormone therapies, such as the contraceptive pill and HRT, are considered a weak risk factor for developing breast cancer, along with things like diet, being overweight, alcohol and even being tall.'

Dr Sullivan continues, 'Women should not be unduly worried about this particular report, unless they do have a strong family history of breast cancer and then it is vital to consult with their doctor.

Experts warn that it is extremely important to bear in mind that the study in no way suggests the Pill causes an increased breast cancer risk for all women, as there are advantages of taking it, for example a reduction in the risk of ovarian cancer.

Talk to the experts
Obviously the report's findings need to be kept in perspective. Pill-users can be reassured that firstly the number of women in the high-risk bracket is relatively small and secondly that breast cancer is rare in young women, particularly in the age groups most likely to consider use of the contraceptive pill.

The simple advice if you are thinking about going on the Pill is to consult your doctor so that he/she has all relevant information about your family history and can prescribe the contraceptive safely, say experts.

Further information
Cancer Research UK: www.cancerresearchuk.org

Breakthrough Breast Cancer: www.breakthrough.org.uk

Breast Cancer Care: www.breastcancercare.org.uk

© HMG Worldwide 2003

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