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Risk of breast cancer associated with short-term use of oral contraceptives

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Abstract

Objective

To estimate breast cancer risk associated with short-term (<6 months) oral contraceptive use, and explore variation in estimates by use characteristics and medical, menstrual, and reproductive history.

Methods

We analyzed data from the Women’s Contraceptive and Reproductive Experiences Study. Case subjects were white women and black women, 35–64 years old, diagnosed with invasive breast cancer in July 1994–April 1998. Control subjects identified by random-digit dialing were matched to case subjects by age, race, and study site. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Results

Overall, short-term oral contraceptive use was not associated with breast cancer risk (OR = 1.0; 95% CI = 0.8–1.1). However, significant interaction between short-term use and menopausal status led to an observed increased breast cancer risk in pre-menopausal women (OR = 1.3; 95% CI = 1.0–1.7) and a reduced risk in post-menopausal women (OR = 0.8; 95% CI = 0.6–1.0) associated with short-term use. The association was more pronounced in women with non-contraceptive reasons for use and underlying risk factors for breast cancer.

Conclusions

These associations may result from underlying characteristics of users or unmeasured factors influencing duration of use and breast cancer risk.

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Acknowledgments

We are grateful to the women who participated in the Women’s CARE Study and to all scientists and staff at the research institutions who contributed to the study. This work was supported by the National Institute of Child Health and Human Development, with additional support from the National Cancer Institute, through contracts with Emory University (N01-HD-3-3168), the Fred Hutchinson Cancer Research Center (N01-HD-2-3166), the Karmanos Cancer Institute at Wayne State University (N01-HD-3-3174), the University of Pennsylvania (N01-HD-3-3176), and the University of Southern California (N01-HD-3-3175) and through an intraagency agreement with the Centers for Disease Control and Prevention (Y01-HD-7022). The Centers for Disease Control and Prevention contributed additional staff and computer support. The Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute provided assistance for study sites in Atlanta (N01-PC-67006), Detroit (N01-CN-65064), Los Angeles (N01-PC-67010), and Seattle (N01-CN-0532).

Brian Strom has been a consultant to and funded by Wyeth Pharmaceuticals on other related matters. Ronald T Burkman is a consultant to Pfizer, Inc and Ortho-McNeil Pharmaceuticals, Inc., and receives support from Berlex Laboratories, Ortho-McNeil Pharmaceuticals, Inc, and Organon as a speaker. The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA

    Suzanne G. Folger, Polly A. Marchbanks & Jill A. McDonald

  2. 4770 Buford Highway Northeast, Mailstop K34, Atlanta, GA, 30341, USA

    Suzanne G. Folger

  3. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Leslie Bernstein & Giske Ursin

  4. Department of Nutrition, University of Oslo, Oslo, Norway

    Giske Ursin

  5. Johnson & Johnson Pharmaceutical Research and Development, Titusville, NJ, USA

    Jesse A. Berlin

  6. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Janet R. Daling & Kathleen E. Malone

  7. Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA

    Sandra A. Norman & Brian L. Strom

  8. Cancer Centers Branch, National Cancer Institute, Bethesda, MD, USA

    Linda K. Weiss

  9. Division of Hematology and Oncology, Karmanos Cancer Institute at Wayne State University, Detroit, MI, USA

    Michael S. Simon

  10. Department of Obstetrics and Gynecology, Baystate Medical Center, Springfield, MA, USA

    Ronald T. Burkman

  11. Contraception and Reproductive Health Branch, Center for Population Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA

    Robert Spirtas

Authors
  1. Suzanne G. Folger
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  2. Polly A. Marchbanks
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  3. Jill A. McDonald
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  4. Leslie Bernstein
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  5. Giske Ursin
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  6. Jesse A. Berlin
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  7. Janet R. Daling
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  8. Sandra A. Norman
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  9. Brian L. Strom
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  10. Linda K. Weiss
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  11. Michael S. Simon
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  12. Ronald T. Burkman
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  13. Kathleen E. Malone
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  14. Robert Spirtas
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Corresponding author

Correspondence to Suzanne G. Folger.

Additional information

The majority of the work on this paper was completed while Dr. Berlin was a Professor of Biostatistics at the University of Pennsylvania. Robert Spirtas is retired.

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Folger, S.G., Marchbanks, P.A., McDonald, J.A. et al. Risk of breast cancer associated with short-term use of oral contraceptives. Cancer Causes Control 18, 189–198 (2007). https://doi.org/10.1007/s10552-006-0086-7

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  • DOI: https://doi.org/10.1007/s10552-006-0086-7

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