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Oral Contraceptive Use and the Risk of Breast Cancer in Young Women

In March 1983, preliminary results were published by CDC and the National Institute of Child Health and Human Development from the Cancer and Steroid Hormone Study. This is a case-control study of breast, endometrial, and ovarian cancer in relation to oral contraceptive (OC) use. The preliminary findings suggested that there is no association between OC use and breast cancer (1). Since then, two studies of breast cancer have been published, one suggesting that women who use so-called "high-progestogen"* combination-type OCs before 25 years of age have an increased risk of developing breast cancer before age 37 (2); the other, that women who use OCs before their first term birth have an increased risk of developing breast cancer before age 45 (3). CDC has further analyzed the Cancer and Steroid Hormone Study data to look at these two specific issues.

Table 1 reports the relative risk of breast cancer by duration of use of high-progestogen, combination-type OCs before age 25. No significant association was found between the use of high-progestogen OCs before age 25 and the development of breast cancer before age 37. Similar results were obtained by using as the reference group women who had never used OCs and by restricting the analysis to those women still nulliparous at age 25. Adjustment for known risk factors for breast cancer did not appreciably alter the results.

Table 2 shows the relative risk of breast cancer before age 45 in women who used any OCs before their first full-term pregnancy; only parous women are included. Women who did not use OCs before their first full-term pregnancy constituted the reference group. No significant association was found between use of OCs before first term birth and subsequent development of breast cancer by age 45. Inclusion of nulliparous women and their OC use in this table did not substantially alter the risk estimates. Reported by Epidemiologic Studies Br, Research and Statistics Br, Div of Reproductive Health, Center for Health Promotion and Education, CDC.

Editorial Note

Editorial Note: Different studies have reported conflicting results concerning the risk of breast cancer for young women using OCs (1-11). It is possible that methodologic differences between the studies account for the differences. The Cancer and Steroid Hormone Study data show that (1) use of "high-progestogen" OCs before age 25 does not increase a woman's risk of developing breast cancer before age 37, and (2) use of OCs before first full-term pregnancy does not increase a woman's risk of developing breast cancer before age 45. The Cancer and Steroid Hormone Study is a population-based case-control study. Results were presented in 1983 (1) from the first 6 months of data collected. The data presented here are from the complete 29-month data file.

References

  1. The Centers for Disease Control Cancer and Steroid Hormone Study. Long-term oral contraceptive use and the risk of breast cancer. JAMA 1983;249:1591-5.

  2. Pike MC, Henderson BE, Krailo MD, Duke A, Roy S. Breast cancer in young women and use of oral contraceptives: possible modifying effect of formulation and age at use. Lancet 1983;II:926-30.

  3. McPherson K, Neil A, Vessey MP, Doll R. Oral contraceptives and breast cancer (Letter). Lancet 1983;II:1414-5.

  4. Paffenbarger RS Jr, Fasal E, Simmons ME, et al. Cancer risk as related to use of oral contraceptives during fertile years. Cancer 1977;39:1887-91.

  5. Brinton LA, Williams RR, Hoover RN, Stegens NL, Feinleib M, Fraumeni JF Jr. Breast cancer risk factors among screening program participants. J Natl Cancer Inst 1979;62:37-44.

  6. Vessey MP, Doll R, Jones K, McPherson K, Yeates D. An epidemiological study of oral contraceptives and breast cancer. Br Med J 1979;1:1757-60.

  7. Royal College of General Practitioners. Breast cancer and oral contraceptives: findings in Royal College of General Practitioners' study. Br Med J 1981;282:2089-93.

  8. Pike MC, Henderson BE, Casagrande JT, Rosario I, Gray GE. Oral contraceptive use and early abortion as risk factors for breast cancer in young women. Br J Cancer 1981;43:72-6.

  9. Vessey MP, McPherson K, Yeates D, Doll R. Oral contraceptive use and abortion before first term pregnancy in relation to breast cancer risk. Br J Cancer 1982;45:327-31.

  10. Harris NV, Weiss NS, Francis AM, Polissar L. Breast cancer in relation to patterns of oral contraceptive use. Am J Epidemiol 1982;116:643-51.

  11. Rosenberg L, Miller DR, Kaufman DW, et al. Breast cancer and oral contraceptive use. Am J Epidemiol 1984;119:167-76.

*See footnote to Table 1.

Disclaimer   All MMWR HTML documents published before January 1993 are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.

**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.

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