8 ms·

Any type of hormonal contraceptive may increase risk of breast cancer

104 points by AiaAidan 4y ago

sterlind 4y ago
Statistically significant, but slight (~25% increased risk, on average.) Still not great. Obviously, copper IUDs are an alternative for many, though they have their downsides. One of the big uses of hormonal contraception is managing heavy periods, PMDD and other medical conditions. I had a friend who would throw up for days every time she was on her period. It went away pretty completely on birth control.
- twawaaay 4y ago
  The magnitude of risk increase in percentage has to be understood in context of baseline probability. 25% additional chance of getting hit by lightning and 25% additional chance of getting heart disease are two completely different results -- I don't mind the first but I would be scared by the second. About 13% of women develop breast cancer during their lifetime. 25% increase is then very significant, this is about additional 4% chance of getting cancer.
  - jnwatson 4y ago
    Thank you for the context. The net increase in risk is what I was looking for.
  - projectazorian 4y ago
    > About 13% of women develop breast cancer during their lifetime. 25% increase is then very significant, this is about additional 4% chance of getting cancer. The study didn’t measure lifetime risk, so your assertion is not correct. It measured risk of acquiring breast cancer before age 49. This is not the age when most women get breast cancer. Average age of onset for breast cancer in the US is 62.
    - twawaaay 4y ago
      While you are partly correct, the study just "didn't measure". It means the study does not say anything about getting cancer after 49. What it does not say is that there isn't any increase after the age women typically stop using contraceptives. In particular, since we don't know the mechanism in which contraceptives cause cancer, we can't say whether trend ends when women stop taking them or will increase their chance of getting cancer for the rest of their lives.
      - projectazorian 4y ago
        Yes, however, we have over a half century of data on hormonal contraception at this point, more than enough to measure the effect on lifetime risk. This very large meta-study showed the increased risk is no longer significant about ten years after stopping use: https://pubmed.ncbi.nlm.nih.gov/8656904/ https://pubmed.ncbi.nlm.nih.gov/8656904/ (btw, got that link from this article about the study in the OP, which points out potential confounders: https://www.statnews.com/2023/03/21/small-rise-breast-cancer-risk-hormonal-birth-control-study/ https://www.statnews.com/2023/03/21/small-rise-breast-cancer...)
yieldcrv 4y ago
> The researchers also note that although these findings provide evidence about the short-term associations between hormonal contraceptives and breast cancer risk, they do not provide information regarding longer-term associations, or the impact of total duration of contraceptive use on breast cancer risk, since information on a woman’s prescription record prior to joining a participating GP practice would not have been available within the CPRD database.
blindriver 4y ago
Every single girlfriend I had, I asked her to get off contraceptives because of the medical dangers and I didn't want to be responsible for any problems associated with it. Instead I took responsibility for making sure she wouldn't get pregnant. One of my girlfriends actually got mad at me because I was *too* careful about getting her pregnant, and interpreted that as me not wanting to get married to her (which since we're not together ended up being true I guess). This doesn't work for everyone but I'm fairly responsible, and no accidental pregnancies, so it worked for everyone I was with. The same way went for my wife as well, and we have 2 kids now, with no accidentals ones. I'm going to teach my son this as well, that the responsibility is on both parties but as the man you need to control what you can control and don't leave things to chance, especially something as life changing/destroying as an accidental pregnancy.
- lazyasciiart 4y ago
  Wow. I'd probably break up with a guy who "asked me to get off contraceptives". If you want to be responsible about preventing pregnancy, that's fantastic. If you feel like that's any more than an input to her decision of whether to be on it, that's a pretty fundamental overreach.
  - warent 4y ago
    Maybe I'm being overly generous, it seems like it may be possible for this kind of thing to be more of a request out of support/concern for a loved one's health, rather than one of control or knowing better than a woman. It has been my understanding that many men don't consider such things. My lady has had horrendous experiences with hormonal contraceptives. Based on what we know of it, if she ever expressed wanting to try it again, I'd ask she reconsiders, or that we explore other options. She would appreciate that as being thoughtful (not as me claiming to know what's better for her, better than herself.) Maybe it's all about context, I'm not sure
    - practice9 4y ago
      > Maybe it's all about context, I'm not sure +100 For everyone the circumstances and relationship dynamics are different. And it's kind of disheartening to read a well-intentioned comment, see people assuming their own completely different context and then getting slightly aggressive about it.
sacrosancty 4y ago
[flagged]
- phnofive 4y ago
  Taking this at face value, I don't think so - but it has been linked with cervical and uterine cancers.
fnordpiglet 4y ago
After I had the kids I wanted, I got a vasectomy. It’s a painless and quick and largely reversible procedure with no side effects and offers 100% contraception. If you care about your partner and are “done,” I highly recommend it.
- emodendroket 4y ago
  That's all well and good but there are a lot of situations where women go for birth control where that isn't much of an option.
  - fnordpiglet 4y ago
    I certainly didn’t say anything to preclude that. In fact unless the woman is certain of the man, she should control her own contraception. The consequence of a mistake falls disproportionately on her and, well, men are pretty much all assholes, even the well intentioned ones. My message, though, was for men - not for women. Vasectomies are a man’s choice, and the only one we can make that fully insulates the woman in our life from the consequences of sex. Any other measure a man can take is pretty poor in it’s effectiveness.
- AiaAidan 4y ago
  Thanks for sharing your positive experience - it's great to hear that the procedure was painless and quick, and has given you and your partner a reliable form of contraception. More important, having a close person in your life whom you can trust is truly a life jackpot! In the current "epidemic of loneliness," it's more important than ever to have strong personal connections.
- gnicholas 4y ago
  A few of my friends have looked into this and decided against because it is actually not as reversible as they initially thought. What did your doctor tell you about reversibility?
  - fnordpiglet 4y ago
yamrzou 4y ago
The title is misleading. It should be: Any type of hormonal contraceptive is associated with an increased risk of breast cancer.
- LorenPechtel 4y ago
  Yeah--there's a factor here that messes up the data. Namely, that pregnancy to term is associated with a *reduction* in breast cancer, the earlier the pregnancy the bigger the effect. This is the reason behind the "pro-life" claim that abortion causes breast cancer--no, it simply doesn't provide the protection. Never-pregnant vs had-abortion is the same risk. Hormonal contraception is more effective and will reduce the oops rate and thus would be expected to show a positive correlation with breast cancer. (And the oops rate is also why for a young non-smoker the risk of the pill is *negative* even if the response to an oops is an immediate abortion. Carrying it to term increases the effect by at least an order of magnitude.)
  - yamrzou 4y ago
    I think that factor is taken into account here: > These calculations were then adjusted to take into account established risk factors such as body mass index (BMI), number of recorded births, and the time since a woman’s last birth. Is it the same as yours?
    - LorenPechtel 4y ago
      The age of *first* birth matters, not the age of last birth. They controlled on the wrong thing.
projectazorian 4y ago
The headline is somewhat deceptive. This study doesn’t assess lifetime risk, just risk before age 49. Since most breast cancers are diagnosed well after age 49, it needs to be assessed in that light.
justinator 4y ago
Hopefully soon, doctors that prescribe birth control for things unrelated to birth control will now stop doing that as that's a reasonably bad thing to do (IMHO IANAD)
- cfu28 4y ago
  I mean, this isn’t new information for doctors. It’s a pretty well known fact that estrogen agonists can increase risks for breast cancer - that’s why decisions made about birth control are patient centric and consider the patients risk factors. For reference, risks of breast and cervical cancers are increased in women who use oral contraceptives, whereas the risks of endometrial, ovarian, and colorectal cancers are actually reduced. Also IANAD
- emodendroket 4y ago
  Is there some other solution for the problems it solves?
  - justinator 4y ago
    Birth control is sometimes prescribed to help with heavy period flow, which could be a symptom of a much worst issue (endometriosis). But birth control is also prescribed to help control acne, which in my humble, unprofessional opinion is not a good use, and the risks far outweigh the benefit. Weight loss is another reason it's prescribed. These sorts of off-label perscription for a hormone are not... great IMHO. Are there other solutions to acne, and weight loss? Yes. Endometriosis is far more complicated.
    - emodendroket 4y ago
      It also is used to help with irregularities associated with periods. Seems like sidestepping the issue to say there are other acne remedies.
      - justinator 4y ago
        >Seems like sidestepping the issue to say there are other acne remedies. My opinion is that estrogen hormone therapy is not the best course of action for acne and is prescribed far too much. I literally do not know what your beef is with my opinion, since you do not state yours, you just write in weird, obtuse statements, which is common on hn in, I would assume, an attempt to look smart on a subject, in which you are not. See also: contrarianism.
twawaaay 4y ago
In general any type of hormonal anything is probably dangerous. Endocrine system is incredibly complex and connected in many different, mostly unknown ways. And contraceptives play with hormones that are central to what makes women women. These hormones are not just limited to regulating when eggs are released from ovaries, they take part in a lot of other processes. It is absolutely not surprising then that there will be other effects of long term hormonal supplementation. I think the best course of action would be to work on other, non-hormonal contraceptive alternatives.
- lockhouse 4y ago
  I’m curious if hormonal transgender treatments will have similar long term effects.
  - jolux 4y ago
    It’s already suspected though not proven (as far as I know) that estradiol increases breast cancer risk, but I imagine most of that is because it encourages significant breast tissue growth.
    - ghqst 4y ago
      If I remember correctly this is at high dosages, so it should be much safer in a normal dosage used for hrt.
      - gizmo686 4y ago
        HRT as applied to gender dysphoria in transgender women absolutely causes breast tissue growth. That is one of the desired effects. Seeing as 99% of breast cancers occur in women, and HRT causes the patient to have very female like breasts, it would be surprising if the patient did not see an increased risk of breast cancer compared to not taking HRT. Weather or not their risk is higher than the baseline risk for women is less obvious.
  - NineStarPoint 4y ago
AiaAidan 4y ago
[flagged]
- fsckboy 4y ago
  [flagged]
  - emodendroket 4y ago
    So you'd prefer we use dysphemisms that support your view of it instead.
    - fsckboy 4y ago
      sterilization isn't my view, it's what it is. permanent birth control could include suicide, it's ambiguous. the only reason one would avoid what you are terming dysphemisms is if you are advocating that people do more of something and you wish to hide what it is.
      - emodendroket 4y ago
        Calling abortion (which is only one element of what is meant by “reproductive freedom”) “terminating reproductees with extreme prejudice” is a dysphemism by any reasonable standard.
- _cenw 4y ago
  Okay ChatGPT.
  - deleted 4y ago
    [deleted]

104 points by AiaAidan 4y ago

Statistically significant, but slight (~25% increased risk, on average.) Still not great. Obviously, copper IUDs are an alternative for many, though they have their downsides. One of the big uses of hormonal contraception is managing heavy periods, PMDD and other medical conditions. I had a friend who would throw up for days every time she was on her period. It went away pretty completely on birth control.

twawaaay 4y ago
The magnitude of risk increase in percentage has to be understood in context of baseline probability. 25% additional chance of getting hit by lightning and 25% additional chance of getting heart disease are two completely different results -- I don't mind the first but I would be scared by the second. About 13% of women develop breast cancer during their lifetime. 25% increase is then very significant, this is about additional 4% chance of getting cancer.
- jnwatson 4y ago
  Thank you for the context. The net increase in risk is what I was looking for.
- projectazorian 4y ago
  > About 13% of women develop breast cancer during their lifetime. 25% increase is then very significant, this is about additional 4% chance of getting cancer. The study didn’t measure lifetime risk, so your assertion is not correct. It measured risk of acquiring breast cancer before age 49. This is not the age when most women get breast cancer. Average age of onset for breast cancer in the US is 62.
  - twawaaay 4y ago
    While you are partly correct, the study just "didn't measure". It means the study does not say anything about getting cancer after 49. What it does not say is that there isn't any increase after the age women typically stop using contraceptives. In particular, since we don't know the mechanism in which contraceptives cause cancer, we can't say whether trend ends when women stop taking them or will increase their chance of getting cancer for the rest of their lives.
    - projectazorian 4y ago
      Yes, however, we have over a half century of data on hormonal contraception at this point, more than enough to measure the effect on lifetime risk. This very large meta-study showed the increased risk is no longer significant about ten years after stopping use: https://pubmed.ncbi.nlm.nih.gov/8656904/ https://pubmed.ncbi.nlm.nih.gov/8656904/ (btw, got that link from this article about the study in the OP, which points out potential confounders: https://www.statnews.com/2023/03/21/small-rise-breast-cancer-risk-hormonal-birth-control-study/ https://www.statnews.com/2023/03/21/small-rise-breast-cancer...)

yieldcrv 4y ago

> The researchers also note that although these findings provide evidence about the short-term associations between hormonal contraceptives and breast cancer risk, they do not provide information regarding longer-term associations, or the impact of total duration of contraceptive use on breast cancer risk, since information on a woman’s prescription record prior to joining a participating GP practice would not have been available within the CPRD database.

blindriver 4y ago

Every single girlfriend I had, I asked her to get off contraceptives because of the medical dangers and I didn't want to be responsible for any problems associated with it. Instead I took responsibility for making sure she wouldn't get pregnant. One of my girlfriends actually got mad at me because I was *too* careful about getting her pregnant, and interpreted that as me not wanting to get married to her (which since we're not together ended up being true I guess). This doesn't work for everyone but I'm fairly responsible, and no accidental pregnancies, so it worked for everyone I was with. The same way went for my wife as well, and we have 2 kids now, with no accidentals ones. I'm going to teach my son this as well, that the responsibility is on both parties but as the man you need to control what you can control and don't leave things to chance, especially something as life changing/destroying as an accidental pregnancy.

lazyasciiart 4y ago
Wow. I'd probably break up with a guy who "asked me to get off contraceptives". If you want to be responsible about preventing pregnancy, that's fantastic. If you feel like that's any more than an input to her decision of whether to be on it, that's a pretty fundamental overreach.
- warent 4y ago
  Maybe I'm being overly generous, it seems like it may be possible for this kind of thing to be more of a request out of support/concern for a loved one's health, rather than one of control or knowing better than a woman. It has been my understanding that many men don't consider such things. My lady has had horrendous experiences with hormonal contraceptives. Based on what we know of it, if she ever expressed wanting to try it again, I'd ask she reconsiders, or that we explore other options. She would appreciate that as being thoughtful (not as me claiming to know what's better for her, better than herself.) Maybe it's all about context, I'm not sure
  - practice9 4y ago
    > Maybe it's all about context, I'm not sure +100 For everyone the circumstances and relationship dynamics are different. And it's kind of disheartening to read a well-intentioned comment, see people assuming their own completely different context and then getting slightly aggressive about it.

sacrosancty 4y ago

[flagged]

phnofive 4y ago
Taking this at face value, I don't think so - but it has been linked with cervical and uterine cancers.

fnordpiglet 4y ago

After I had the kids I wanted, I got a vasectomy. It’s a painless and quick and largely reversible procedure with no side effects and offers 100% contraception. If you care about your partner and are “done,” I highly recommend it.

emodendroket 4y ago
That's all well and good but there are a lot of situations where women go for birth control where that isn't much of an option.
- fnordpiglet 4y ago
  I certainly didn’t say anything to preclude that. In fact unless the woman is certain of the man, she should control her own contraception. The consequence of a mistake falls disproportionately on her and, well, men are pretty much all assholes, even the well intentioned ones. My message, though, was for men - not for women. Vasectomies are a man’s choice, and the only one we can make that fully insulates the woman in our life from the consequences of sex. Any other measure a man can take is pretty poor in it’s effectiveness.
AiaAidan 4y ago
Thanks for sharing your positive experience - it's great to hear that the procedure was painless and quick, and has given you and your partner a reliable form of contraception. More important, having a close person in your life whom you can trust is truly a life jackpot! In the current "epidemic of loneliness," it's more important than ever to have strong personal connections.
gnicholas 4y ago
A few of my friends have looked into this and decided against because it is actually not as reversible as they initially thought. What did your doctor tell you about reversibility?
- fnordpiglet 4y ago

yamrzou 4y ago

The title is misleading. It should be: Any type of hormonal contraceptive is associated with an increased risk of breast cancer.

LorenPechtel 4y ago
Yeah--there's a factor here that messes up the data. Namely, that pregnancy to term is associated with a *reduction* in breast cancer, the earlier the pregnancy the bigger the effect. This is the reason behind the "pro-life" claim that abortion causes breast cancer--no, it simply doesn't provide the protection. Never-pregnant vs had-abortion is the same risk. Hormonal contraception is more effective and will reduce the oops rate and thus would be expected to show a positive correlation with breast cancer. (And the oops rate is also why for a young non-smoker the risk of the pill is *negative* even if the response to an oops is an immediate abortion. Carrying it to term increases the effect by at least an order of magnitude.)
- yamrzou 4y ago
  I think that factor is taken into account here: > These calculations were then adjusted to take into account established risk factors such as body mass index (BMI), number of recorded births, and the time since a woman’s last birth. Is it the same as yours?
  - LorenPechtel 4y ago
    The age of *first* birth matters, not the age of last birth. They controlled on the wrong thing.

projectazorian 4y ago

The headline is somewhat deceptive. This study doesn’t assess lifetime risk, just risk before age 49. Since most breast cancers are diagnosed well after age 49, it needs to be assessed in that light.

justinator 4y ago

Hopefully soon, doctors that prescribe birth control for things unrelated to birth control will now stop doing that as that's a reasonably bad thing to do (IMHO IANAD)

cfu28 4y ago
I mean, this isn’t new information for doctors. It’s a pretty well known fact that estrogen agonists can increase risks for breast cancer - that’s why decisions made about birth control are patient centric and consider the patients risk factors. For reference, risks of breast and cervical cancers are increased in women who use oral contraceptives, whereas the risks of endometrial, ovarian, and colorectal cancers are actually reduced. Also IANAD
emodendroket 4y ago
Is there some other solution for the problems it solves?
- justinator 4y ago
  Birth control is sometimes prescribed to help with heavy period flow, which could be a symptom of a much worst issue (endometriosis). But birth control is also prescribed to help control acne, which in my humble, unprofessional opinion is not a good use, and the risks far outweigh the benefit. Weight loss is another reason it's prescribed. These sorts of off-label perscription for a hormone are not... great IMHO. Are there other solutions to acne, and weight loss? Yes. Endometriosis is far more complicated.
  - emodendroket 4y ago
    It also is used to help with irregularities associated with periods. Seems like sidestepping the issue to say there are other acne remedies.
    - justinator 4y ago
      >Seems like sidestepping the issue to say there are other acne remedies. My opinion is that estrogen hormone therapy is not the best course of action for acne and is prescribed far too much. I literally do not know what your beef is with my opinion, since you do not state yours, you just write in weird, obtuse statements, which is common on hn in, I would assume, an attempt to look smart on a subject, in which you are not. See also: contrarianism.

twawaaay 4y ago

In general any type of hormonal anything is probably dangerous. Endocrine system is incredibly complex and connected in many different, mostly unknown ways. And contraceptives play with hormones that are central to what makes women women. These hormones are not just limited to regulating when eggs are released from ovaries, they take part in a lot of other processes. It is absolutely not surprising then that there will be other effects of long term hormonal supplementation. I think the best course of action would be to work on other, non-hormonal contraceptive alternatives.

lockhouse 4y ago
I’m curious if hormonal transgender treatments will have similar long term effects.
- jolux 4y ago
  It’s already suspected though not proven (as far as I know) that estradiol increases breast cancer risk, but I imagine most of that is because it encourages significant breast tissue growth.
  - ghqst 4y ago
    If I remember correctly this is at high dosages, so it should be much safer in a normal dosage used for hrt.
    - gizmo686 4y ago
      HRT as applied to gender dysphoria in transgender women absolutely causes breast tissue growth. That is one of the desired effects. Seeing as 99% of breast cancers occur in women, and HRT causes the patient to have very female like breasts, it would be surprising if the patient did not see an increased risk of breast cancer compared to not taking HRT. Weather or not their risk is higher than the baseline risk for women is less obvious.
- NineStarPoint 4y ago

AiaAidan 4y ago

[flagged]

fsckboy 4y ago
[flagged]
- emodendroket 4y ago
  So you'd prefer we use dysphemisms that support your view of it instead.
  - fsckboy 4y ago
    sterilization isn't my view, it's what it is. permanent birth control could include suicide, it's ambiguous. the only reason one would avoid what you are terming dysphemisms is if you are advocating that people do more of something and you wish to hide what it is.
    - emodendroket 4y ago
      Calling abortion (which is only one element of what is meant by “reproductive freedom”) “terminating reproductees with extreme prejudice” is a dysphemism by any reasonable standard.
_cenw 4y ago
Okay ChatGPT.
- deleted 4y ago
  [deleted]