Skip to main content
PMC home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1989 Sep;60(3):375–381. doi: 10.1038/bjc.1989.288

Oral contraceptives and breast cancer: results from an expanded case-control study.

J L Stanford 1, L A Brinton 1, R N Hoover 1
PMCID: PMC2247191  PMID: 2789945

Abstract

The relationship between oral contraceptives and breast cancer was evaluated among 2,022 cases and 2,183 controls participating in a multicentre breast cancer screening programme. Ever use of oral contraceptives was not related to breast cancer risk (RR = 1.0, 95% CI 0.9-1.2), and no overall patterns of increasing or decreasing risks were observed according to the duration of use, or time since first or most recent use. Although we had no women with extended periods of oral contraceptive use early in life, no evidence of adverse effects attributable to short-term use before age 25, before first live birth or during the perimenopausal period were observed. Further, oral contraceptives did not interact with other breast cancer risk factors, except among those with a history of two or more breast biopsies (RR = 2.0). Analyses by stage of disease revealed that risk was related to the duration of oral contraceptive use: greater than or equal to 5 years use was associated with reduced risk for in situ cancer (RR = 0.59) and increased risks for invasive cancers (RR = 1.5 and 1.4 respectively for small and large lesions). These data suggest that oral contraceptive effects may vary by stage of disease, but provide no overall evidence of an association between oral contraceptives and breast cancer.

Full text

PDF
377

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Black M. M., Kwon C. S., Leis H. P., Jr, Barclay T. H. Family history and oral contraceptives: unique relationships in breast cancer patients. Cancer. 1980 Dec 15;46(12):2747–2751. doi: 10.1002/1097-0142(19801215)46:12<2747::aid-cncr2820461235>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
  2. Breast cancer and oral contraceptives: findings in Royal College of General Practitioners' study. Br Med J (Clin Res Ed) 1981 Jun 27;282(6282):2089–2093. doi: 10.1136/bmj.282.6282.2089. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brinton L. A., Hoover R., Fraumeni J. F., Jr Epidemiology of minimal breast cancer. JAMA. 1983 Jan 28;249(4):483–487. [PubMed] [Google Scholar]
  4. Brinton L. A., Hoover R., Fraumeni J. F., Jr Menopausal oestrogens and breast cancer risk: an expanded case-control study. Br J Cancer. 1986 Nov;54(5):825–832. doi: 10.1038/bjc.1986.246. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Brinton L. A., Hoover R., Szklo M., Fraumeni J. F., Jr Oral contraceptives and breast cancer. Int J Epidemiol. 1982 Dec;11(4):316–322. doi: 10.1093/ije/11.4.316. [DOI] [PubMed] [Google Scholar]
  6. Brinton L. A., Schairer C., Stanford J. L., Hoover R. N. Cigarette smoking and breast cancer. Am J Epidemiol. 1986 Apr;123(4):614–622. doi: 10.1093/oxfordjournals.aje.a114281. [DOI] [PubMed] [Google Scholar]
  7. Brinton L. A., Williams R. R., Hoover R. N., Stegens N. L., Feinleib M., Fraumeni J. F., Jr Breast cancer risk factors among screening program participants. J Natl Cancer Inst. 1979 Jan;62(1):37–44. [PubMed] [Google Scholar]
  8. Fasal E., Paffenbarger R. S., Jr Oral contraceptives as related to cancer and benign lesions of the breast. J Natl Cancer Inst. 1975 Oct;55(4):767–773. doi: 10.1093/jnci/55.4.767. [DOI] [PubMed] [Google Scholar]
  9. Harris N. V., Weiss N. S., Francis A. M., Polissar L. Breast cancer in relation to patterns of oral contraceptive use. Am J Epidemiol. 1982 Oct;116(4):643–651. doi: 10.1093/oxfordjournals.aje.a113447. [DOI] [PubMed] [Google Scholar]
  10. Henderson B. E., Ross R. K., Pike M. C., Casagrande J. T. Endogenous hormones as a major factor in human cancer. Cancer Res. 1982 Aug;42(8):3232–3239. [PubMed] [Google Scholar]
  11. Janerich D. T., Polednak A. P., Glebatis D. M., Lawrence C. E. Breast cancer and oral contraceptive use: a case-control study. J Chronic Dis. 1983;36(9):639–646. doi: 10.1016/0021-9681(83)90080-2. [DOI] [PubMed] [Google Scholar]
  12. Jick H., Walker A. M., Watkins R. N., D'Ewart D. C., Hunter J. R., Danford A., Madsen S., Dinan B. J., Rothman K. J. Oral contraceptives and breast cancer. Am J Epidemiol. 1980 Nov;112(5):577–585. doi: 10.1093/oxfordjournals.aje.a113030. [DOI] [PubMed] [Google Scholar]
  13. Kay C. R., Hannaford P. C. Breast cancer and the pill--a further report from the Royal College of General Practitioners' oral contraception study. Br J Cancer. 1988 Nov;58(5):675–680. doi: 10.1038/bjc.1988.285. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Kelsey J. L., Fischer D. B., Holford T. R., LiVoisi V. A., Mostow E. D., Goldenberg I. S., White C. Exogenous estrogens and other factors in the epidemiology of breast cancer. J Natl Cancer Inst. 1981 Aug;67(2):327–333. [PubMed] [Google Scholar]
  15. La Vecchia C., Decarli A., Fasoli M., Franceschi S., Gentile A., Negri E., Parazzini F., Tognoni G. Oral contraceptives and cancers of the breast and of the female genital tract. Interim results from a case-control study. Br J Cancer. 1986 Aug;54(2):311–317. doi: 10.1038/bjc.1986.178. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Lees A. W., Burns P. E., Grace M. Oral contraceptives and breast disease in premenopausal Northern Albertan women. Int J Cancer. 1978 Dec;22(6):700–707. doi: 10.1002/ijc.2910220611. [DOI] [PubMed] [Google Scholar]
  17. Lubin J. H. A computer program for the analysis of matched case-control studies. Comput Biomed Res. 1981 Apr;14(2):138–143. doi: 10.1016/0010-4809(81)90031-8. [DOI] [PubMed] [Google Scholar]
  18. Matthews P. N., Millis R. R., Hayward J. L. Breast cancer in women who have taken contraceptive steroids. Br Med J (Clin Res Ed) 1981 Mar 7;282(6266):774–776. doi: 10.1136/bmj.282.6266.774. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. McPherson K., Neil A., Vessey M. P., Doll R. Oral contraceptives and breast cancer. Lancet. 1983 Dec 17;2(8364):1414–1415. doi: 10.1016/s0140-6736(83)90936-4. [DOI] [PubMed] [Google Scholar]
  20. McPherson K., Vessey M. P., Neil A., Doll R., Jones L., Roberts M. Early oral contraceptive use and breast cancer: results of another case-control study. Br J Cancer. 1987 Nov;56(5):653–660. doi: 10.1038/bjc.1987.261. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Meirik O., Lund E., Adami H. O., Bergström R., Christoffersen T., Bergsjö P. Oral contraceptive use and breast cancer in young women. A joint national case-control study in Sweden and Norway. Lancet. 1986 Sep 20;2(8508):650–654. doi: 10.1016/s0140-6736(86)90166-2. [DOI] [PubMed] [Google Scholar]
  22. Millard F. C., Bliss J. M., Chilvers C. E., Gazet J. C. Oral contraceptives and survival in breast cancer. Br J Cancer. 1987 Sep;56(3):377–378. doi: 10.1038/bjc.1987.206. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Miller D. R., Rosenberg L., Kaufman D. W., Schottenfeld D., Stolley P. D., Shapiro S. Breast cancer risk in relation to early oral contraceptive use. Obstet Gynecol. 1986 Dec;68(6):863–868. [PubMed] [Google Scholar]
  24. Olsson H., Olsson M. L., Möller T. R., Ranstam J., Holm P. Oral contraceptive use and breast cancer in young women in Sweden. Lancet. 1985 Mar 30;1(8431):748–749. doi: 10.1016/s0140-6736(85)91280-2. [DOI] [PubMed] [Google Scholar]
  25. Oral-contraceptive use and the risk of breast cancer. The Cancer and Steroid Hormone Study of the Centers for Disease Control and the National Institute of Child Health and Human Development. N Engl J Med. 1986 Aug 14;315(7):405–411. doi: 10.1056/NEJM198608143150701. [DOI] [PubMed] [Google Scholar]
  26. Paffenbarger R. S., Jr, Fasal E., Simmons M. E., Kampert J. B. Cancer risk as related to use of oral contraceptives during fertile years. Cancer. 1977 Apr;39(4 Suppl):1887–1891. doi: 10.1002/1097-0142(197704)39:4+<1887::aid-cncr2820390822>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  27. Paffenbarger R. S., Jr, Kampert J. B., Chang H. G. Characteristics that predict risk of breast cancer before and after the menopause. Am J Epidemiol. 1980 Aug;112(2):258–268. doi: 10.1093/oxfordjournals.aje.a112992. [DOI] [PubMed] [Google Scholar]
  28. Paul C., Skegg D. C., Spears G. F., Kaldor J. M. Oral contraceptives and breast cancer: a national study. Br Med J (Clin Res Ed) 1986 Sep 20;293(6549):723–726. doi: 10.1136/bmj.293.6549.723. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Pike M. C., Henderson B. E., Casagrande J. T., Rosario I., Gray G. E. Oral contraceptive use and early abortion as risk factors for breast cancer in young women. Br J Cancer. 1981 Jan;43(1):72–76. doi: 10.1038/bjc.1981.10. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Pike M. C., Henderson B. E., Krailo M. D., 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 Oct 22;2(8356):926–930. doi: 10.1016/s0140-6736(83)90450-6. [DOI] [PubMed] [Google Scholar]
  31. Prentice R. L., Thomas D. B. On the epidemiology of oral contraceptives and disease. Adv Cancer Res. 1987;49:285–401. doi: 10.1016/s0065-230x(08)60801-5. [DOI] [PubMed] [Google Scholar]
  32. Ravnihar B., Primic Zakelj M., Kosmelj K., Stare J. A case-control study of breast cancer in relation to oral contraceptive use in Slovenia. Neoplasma. 1988;35(1):109–121. [PubMed] [Google Scholar]
  33. Rosenberg L., Miller D. R., Kaufman D. W., Helmrich S. P., Stolley P. D., Schottenfeld D., Shapiro S. Breast cancer and oral contraceptive use. Am J Epidemiol. 1984 Feb;119(2):167–176. doi: 10.1093/oxfordjournals.aje.a113735. [DOI] [PubMed] [Google Scholar]
  34. Rosner D., Lane W. W. Oral contraceptive use has no adverse effect on the prognosis of breast cancer. Cancer. 1986 Feb 1;57(3):591–596. doi: 10.1002/1097-0142(19860201)57:3<591::aid-cncr2820570333>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  35. Schlesselman J. J., Stadel B. V., Murray P., Lai S. Breast cancer in relation to early use of oral contraceptives. No evidence of a latent effect. JAMA. 1988 Mar 25;259(12):1828–1833. [PubMed] [Google Scholar]
  36. Skegg D. C. Potential for bias in case-control studies of oral contraceptives and breast cancer. Am J Epidemiol. 1988 Feb;127(2):205–212. doi: 10.1093/oxfordjournals.aje.a114796. [DOI] [PubMed] [Google Scholar]
  37. Spencer J. D., Millis R. R., Hayward J. L. Contraceptive steroids and breast cancer. Br Med J. 1978 Apr 22;1(6119):1024–1026. doi: 10.1136/bmj.1.6119.1024. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Stadel B. V., Rubin G. L., Webster L. A., Schlesselman J. J., Wingo P. A. Oral contraceptives and breast cancer in young women. Lancet. 1985 Nov 2;2(8462):970–973. doi: 10.1016/s0140-6736(85)90524-0. [DOI] [PubMed] [Google Scholar]
  39. Trapido E. J. A prospective cohort study of oral contraceptives and breast cancer. J Natl Cancer Inst. 1981 Nov;67(5):1011–1015. [PubMed] [Google Scholar]
  40. Vessey M. P., McPherson K., Doll R. Breast cancer and oral contraceptives: findings in Oxford-Family Planning Association contraceptive study. Br Med J (Clin Res Ed) 1981 Jun 27;282(6282):2093–2094. doi: 10.1136/bmj.282.6282.2093. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Vessey M. P., 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 Mar;45(3):327–331. doi: 10.1038/bjc.1982.58. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Vessey M., Baron J., Doll R., McPherson K., Yeates D. Oral contraceptives and breast cancer: final report of an epidemiological study. Br J Cancer. 1983 Apr;47(4):455–462. doi: 10.1038/bjc.1983.74. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES