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Contemporary Hormonal Contraception and the Risk of Breast Cancer

Discussion in 'Fred's House of Pancakes' started by bwilson4web, Dec 9, 2017.

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Taking the pill

Poll closed Dec 30, 2017.
  1. Only abstinence and barrier methods should be used.

    1 vote(s)
    33.3%
  2. Increase breast cancer screening in future.

    0 vote(s)
    0.0%
  3. Need to see confirmation studies.

    1 vote(s)
    33.3%
  4. Contact Dewey, Cheatum, and Howl at 1-888-***-****

    0 vote(s)
    0.0%
  5. Honey, where is the pie?

    1 vote(s)
    33.3%
  1. bwilson4web

    bwilson4web BMW i3 and Model 3

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    Source: http://www.nejm.org/doi/full/10.1056/NEJMoa1700732

    Results

    Among 1.8 million women who were followed on average for 10.9 years (a total of 19.6 million person-years), 11,517 cases of breast cancer occurred. As compared with women who had never used hormonal contraception, the relative risk of breast cancer among all current and recent users of hormonal contraception was 1.20 (95% confidence interval [CI], 1.14 to 1.26). This risk increased from 1.09 (95% CI, 0.96 to 1.23) with less than 1 year of use to 1.38 (95% CI, 1.26 to 1.51) with more than 10 years of use (P=0.002). After discontinuation of hormonal contraception, the risk of breast cancer was still higher among the women who had used hormonal contraceptives for 5 years or more than among women who had not used hormonal contraceptives. Risk estimates associated with current or recent use of various oral combination (estrogen–progestin) contraceptives varied between 1.0 and 1.6. Women who currently or recently used the progestin-only intrauterine system also had a higher risk of breast cancer than women who had never used hormonal contraceptives (relative risk, 1.21; 95% CI, 1.11 to 1.33). The overall absolute increase in breast cancers diagnosed among current and recent users of any hormonal contraceptive was 13 (95% CI, 10 to 16) per 100,000 person-years, or approximately 1 extra breast cancer for every 7690 women using hormonal contraception for 1 year.

    There are people who would exploit this for their own purposes. For example, lawyers change their TV ads to solicit cases based upon anything from talcum powder to trucks to texting to any medical device/medicine/treatment. So I have no doubt that someone is crafting a lawyer TV add,

    'Do you have breast cancer and used an oral contraceptive? Contact the law firm of Dewy, Cheatum, and Howl for compensation.'

    Breast cancer is not trivial and I've not read the full report to make sure all secondary effects have been addressed. Taking an oral contraceptive means barrier methods that block other transmissions may occur leading to other medical conditions that _MAY_ have a cancer risk like HPV.

    So I'm not convinced from the lay reports and this summary there is enough to draw a conclusion that should change behavior. But to keep things in perspective

    "1 extra brest cancer for every 7690 women using hormonal contraception for 1 year."​

    Bob Wilson
     
  2. RCO

    RCO Senior Member

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    This is a subject I don't feel comfortable with handling in public.
     
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  3. bwilson4web

    bwilson4web BMW i3 and Model 3

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    I understand since my late Dad was a physician and for a while a pathologist and county coroner. My Mom is a retired RN and accountant who used to run my Dad's medical practice. So it wasn't until I went away to college that others pointed out you don't hold your knife like a scalpel to dissect your dinner. But we have a dark history about such subjects in the USA.

    In the early 1960s, some States made contraceptives illegal until a USA Supreme Court case tossed those laws out out:


    This case established a right to privacy that eventually eliminated blanket abortion bans. That doesn't mean everyone agrees with either so every decade or so the honorable competition drags out some dodgy 'study' that claims the superiority of nonsense.

    My interest in this subject is based on how the thinnest claims are grasped by those with an agenda to assert some total nonsense. I'm afraid this medical study will be abused for the same. If confirmed by other, credible epidemiology studies, the right answer would be to increase screening for those at what is a very low risk, 1/7690 = 0.013%.

    Bob Wilson
     
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  4. RCO

    RCO Senior Member

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    I take your point, really I do. Having survived cancer myself I value all positive announcements about improved or reduced survival. But sadly, my inner demon took over briefly and I was being obliquely humerous about 'handling breasts' in public. Now I shall be publicly reviled by our female readers.:cry:
     
  5. bisco

    bisco cookie crumbler

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    i prefer to live as naturally as possible, ingesting as few man made chemicals as possible. even my cholesterol meds bother me.
     
  6. RCO

    RCO Senior Member

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    Know what you mean. There will be some worse off than me but I'm down to 9 a day.
     
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  7. bisco

    bisco cookie crumbler

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    ny times: one concern is that 2 of the studies authors are former employees of danish pharma company novo nordisk, who funded the study.
     
  8. tochatihu

    tochatihu Senior Member

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    There is extensive literature on breast cancer risk vs. environmental and intentional chemical exposure. It is very challenging to rank them by epidemiology, and we just can't expose people to potential harm in science.

    Better to say it is tightly regulated, I guess.

    For hormonal contraception in particular I suppose it makes sense to compare health risks of non-use because pregnancy and delivery have their own medical risks.

    Also there is some evidence for synergistic effects among chemicals which was not at all the aim of this study.
     
  9. fuzzy1

    fuzzy1 Senior Member

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    And also compare to non-pregnancy-related diseases and conditions that are reduced by hormonal contraception, such as ovarian cancer.

    These drugs have a mixed bag of health side effects. Not including the very obvious primary benefit of avoiding unwanted pregnancies, it still isn't clear to me that the net overall result of the various side effects is positive, negative, or too close to neutral to yet have a clear answer.
     
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  10. RobH

    RobH Senior Member

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    Dr. John Lee specialized in the effects of the hormone progesterone up until his death in 2003. His major observation was that progestin drugs were not equivalent to progesterone. In fact, the action of progestins is to displace progesterone. That's why birth control with progestins works - progesterone is required for pregnancy, and progestins displace it.

    His theories were quite controversial at the time, but have been largely validated. He theorized that progesterone was anti-cancer, and blocking it with progestin drugs would promote cancer. Most of the medical profession regards progestins and progesterone as equivalent, which has certainly been demonstrated to be wrong.

    He was quite the hero for many women who were using HRT for their menopausal symptoms. Replacing the drug HRT with natural progesterone improved many of their lives, at least according to the women. More recent practice by natural oriented doctors generally involves multiple hormones, rather than just progesterone. Dr. Lee started it all.

    Dr. Lee's website is still up, and sells products related to hormone balance. His newsletters are also available there. Website is Official Website of John R. Lee, M.D., Expert in Progesterone and HRT .

    Rumor has it that transdermal progesterone is good for grumpy old men as well...
     
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  11. ETC(SS)

    ETC(SS) The OTHER One Percenter.....

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    Pie?
    Did somebody mention Pie?

    I do not trivialize contraception, and I've seen menopause and manopause through both ends of the telescope.
    However (comma!) since I'm the husband of a wife, father of a daughter, and two granddaughters I've learned that with such things I can offer a point of view.........once.......IF asked.
    Even then.....I get 49.99999 percent of the vote.

    When science finally determines whether caffeine if good for you or bad for you......or butter.....or which way to hold the 'food pyramid' then I will hold it in higher regard.
    As far as manopause is concerned, I'm staying ahead of the skinny dude with the scythe with a fitbit, and 5 acres of land to maintain and chasing grandchildren.....and one aspirin before bed when I can think of it......and no thank you for any advice to the contrary!
    I do not offer young women advice on contraception, nor older ones about the dismal choices on menopause treatment......unless asked.

    What kinda pie?
     
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  12. pilotgrrl

    pilotgrrl Senior Member

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  13. tochatihu

    tochatihu Senior Member

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    You could suggest that by email Ms. Pilot.

    Would make more sense for you to do so because you could add some sincere praise.
     
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  14. Kevin_Denver

    Kevin_Denver Active Member

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    It's not surprising that interfering with nature's normal process shows evidence of increase of cancer. Every girlfriend I've had we've talked about contraceptives, protection, etc. before engaging in you know what, and I've never had a girlfriend not report changes to mood or effects on their body from them.

    There's a new contraceptive for men called Vasalgel that should be coming to market soon. It's basically superglue that gets injected into the vas deferens and blocks it (instead of cutting it in a vasectomy). It works like a temporary vasectomy. When you decide you do want to have kids, they inject a solvent that dissolves it and everything flows again like normal. TMI alert - If the side effects are as low as a vasectomy, I plan to be one of the first to have this done.
     
  15. RCO

    RCO Senior Member

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    Makes a pleasant change from sniffing glue, anyway! :ROFLMAO:
     
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