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Cancer Epidemiology Biomarkers & Prevention Vol. 11, 1375-1381, November 2002
© 2002 American Association for Cancer Research

Use of Oral Contraceptives and Breast Cancer Risk

The Norwegian-Swedish Women’s Lifestyle and Health Cohort Study1

Merethe Kumle2, Elisabete Weiderpass, Tonje Braaten, Ingemar Persson, Hans-Olov Adami and Eiliv Lund

Institute of Community Medicine, University of Tromsoe, 9037 Tromsoe, Norway [M. K., T. B., E. L.]; Department of Medical Epidemiology, Karolinska Institutet, S-17177 Stockholm, Sweden [E. W., H-O. A.]; IARC, F-69372 Lyon, France [E. W.]; and Medical Products Agency, S-75103 Uppsala, Sweden [I. P.]

Current use of oral contraceptives (OCs) has been reportedto increase breast cancer risk slightly. In 1991/1992, a prospective cohort study specifically designed to examine the role of hormonal contraceptives in relation to breast cancer was conducted in Norway and Sweden. This study was entitled Women’s Lifestyle and Health. Of 196,000 invited women aged 30–49 years, 106,844 women answered a 4-page questionnaire. Altogether, 103,027 women providing information on contraceptive use were included in the analysis presented here, and 1,008 primary invasive breast cancers were diagnosed throughout 1999 (end of follow-up). Proportional hazard regression was used to calculate relative risks (RRs) with adjustment for age and other possible confounders. An increased breast cancer risk was observed among women who were current/recent users of OCs of any type at the start of follow-up [RR, 1.6; 96% confidence interval (CI), 1.2–2.1]. Current/recent use (i.e., use in the year preceding cohort enrolment) of combined OCs (RR, 1.5; 95% CI, 1.0–2.0) and progestin-only pills (RR, 1.6; 95% CI, 1.0–2.4) entailed similar levels of increased risk. An increased risk of borderline significance was found among short-term (i.e., less than 13 months) users before age 20 years (RR, 1.3; 95% CI, 1.0–1.7) and before first full-term pregnancy (RR, 1.4; 95% CI, 1.0–1.8). Long-term users of OCs were at a higher risk of breast cancer than never users (test for trend, P = 0.005). Current/recent use of OCs is associated with an increased breast cancer risk. Use of combined OCs and progestin-only pills seem to increase the risk at the same level.




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Copyright © 2002 by the American Association for Cancer Research.