Hormonal Contraception and Cancer Risk
If you have a family history of breast cancer you or your doctor may be wondering about whether it is safe to use the oral contraceptive pill (OCP) or other types of hormonal contraceptives (such as implanted, mini pill or injectable hormones).
Studies vary in their results. Some show no increase in breast cancer risk for women who use the OCP while others show a slight increase in risk.
There is no one safe type of hormonal contraceptive to use.
The use of the OCP for 5 years or more has been shown to reduce ovarian cancer risk but not to the extent it is recommended as the sole strategy for managing this risk in high risk women. Meaning even if women at high lifetime risk of ovarian cancer have used the OCP, they are currently still recommended to consider surgery to remove their ovaries and fallopian tubes at around age 40.
What to Know Before You Decide
There are a few questions you might want to ask that may help you decide about whether the OCP is right for you?
- How much does the pill increase your risk above your background risk of breast cancer?
- What are the reasons for taking the pill?
- Are there any acceptable alternatives?
Understanding what your own risk of breast cancer might be in the next 10 years and then taking into account how much the hormonal contraceptive will increase your risk can help you weigh the benefits and risks. This is because the risk of breast cancer changes as we age. For example, a woman with a low or moderate risk of breast cancer and who is in early adulthood e.g. 20’s, will most likely have a small 10 year risk for breast cancer, therefore any increase in her risk may mean her risk remains relatively low overall. These are women who may be willing to accept the small increase in risk if they are wishing to use the OCP for a short time. In contrast, a woman at high risk of breast cancer and is in her 30’s or 40’s may have a much greater risk of breast cancer than the woman in her 20’s and therefore any small increase in risk may mean it may be reasonable to avoid the OCP in order to avoid any further increases in risk.
Life changes and so can the reason for taking the OCP. Using the OCP for effective contraception can be a very valid reason. However if you or your doctor are consider using it to control acne or period cycling, there are other suitable alternatives to consider first.
If you decide to use a hormonal contraceptive and you are at high risk of breast cancer, it is advised you review that decision regularly and particularly if your situation or reason to use it changes.