NEJM: Oral Contraceptives and the Small Increased Risk of Breast Cancer

Dec 13, 2017

A large prospective study published in the New England Journal of Medicine (NEJM) involving women in Denmark who were younger than 50 years of age showed an association between the use of hormonal contraceptives and the risk of breast cancer. Women who were currently using or had recently used hormonal contraceptives had a 20% higher risk of breast cancer than among those who had never used them. The risk increased with a longer duration of use.

The absolute increase risk, however, remains low (13 per 100,000) particularly for women younger than 35 years of age (2 per 100,000). Most of the breast cancer cases occurred among women older than 40 years of age.

The study also showed a beneficial association between the use of hormone contraceptives and lower risk of ovarian, endometrial, and colorectal cancers.

Patients should discuss with their medical providers regarding the benefits (e.g. effective means of contraception, relief of dysmenorrhea, lower ovarian/endometrial/colorectal cancer) as well as the risks (e.g. blood clots, heart attack and stroke, breast cancer) of hormonal contraceptives.

  • Women younger than 35 years have lower risk for breast cancer and cardiovascular disease and may benefit from hormonal contraceptives use.
  • For women older than 40 or with higher risk for cardiovascular disease or breast cancer, careful consideration of alternative methods of contraception (e.g. non-hormonal IUDs) should be discussed.
  • Lower one’s risk for breast cancer by maintaining optimal weight, exercising and limiting or abstaining from alcohol.