Fillers POEM*

Newer oral contraceptive pill does not increase risk of breast cancer

BMJ 2002; 325 doi: (Published 02 November 2002) Cite this as: BMJ 2002;325:i

Clinical question Does oral contraceptive use increase the risk of breast cancer?

Synopsis A previous pooled analysis of more than 50 studies with more than 150 000 patients (Lancet 1996;347:1713-27) found a slight increase in the risk of breast cancer with previous oral contraceptive use, with a relative risk of 1.1. This risk was lower for patients who took higher dose pills and for those who were currently taking oral contraceptives. However, the quality of studies included in this pooled analysis varied, and many patients used older, high dose oral contraceptives. This new study examined the same question in 4575 American women with breast cancer and 4682 matched controls. Cases were identified from cancer registries in five cities, and controls by random digit dialling. All women were interviewed to determine their history of oral contraceptive use. This well executed case-control study probably represents the highest level of evidence that we will achieve for this question, since randomised trials are not possible. The authors found absolutely no increase in the risk of breast cancer for current oral contraceptive users (adjusted odds ratio 1.0; 95% confidence interval 0.8 to 1.3) or for previous users (0.9; 0.8 to 1.0). There was some geographic variation: oral contraceptives were protective in Atlanta and Detroit but not in Seattle.

Bottom line Use of newer oral contraceptives does not increase the risk of breast cancer in current or previous users.

©infoPOEMs 1992-2002

* Patient-Oriented Evidence that Matters. See editorial (p 983)


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