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Pill protection?

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Express News Service

Posted: Mar 04, 2009 at 0414 hrs IST

Dr Nirja Chawla discusses the relation between oral contraceptive pills & breast cancer

As women are beginning to stand tall, confident of their role in society, the need to make correct choices especially regarding fertility becomes important. When a couple decides not to have a baby, many contraceptive choices open up. Despite Oral Contraceptive Pills (OCP) being a good option, their use is restricted by the fear of developing breast cancer. This issue is complex and often the topic of research and debate.

Extensive data suggests that women who use OCPs after a pregnancy, for spacing of children or after completing their family, have no increased risk of breast cancer. A full-term pregnancy, in some way, seems to be protective, as is breastfeeding, albeit in a smaller way. Younger women who take OCPs before a full-term pregnancy have a slightly more risk, which is higher if the age at start of OCPs is less than 20 years. This higher risk remains till five years after stopping OCPs. One must remember, however, that this is a time period when breast cancer is uncommon. So, the actual number or absolute risk is low. Important also is the finding that breast cancer in such cases is less likely to spread beyond the breast and is easily treatable.

For those who have taken OCPs in the past, there is zero risk 10 years after stopping them. Past users are also protected from breast cancer later in life. The duration of oral contraceptive intake has not been linked with breast cancer and one can take them for long periods of time, up to 15 years, even continuously. Many women are concerned if they have benign diseases of the breast like fibrocystic disease or family history of breast cancer. The risk of breast cancer is not increased with OCPs in these women. They may even be used for contraception if the woman herself has had breast cancer in the past (though not recommended by all organizations), after consultation with your doctor, provided it was treated and the woman is disease-free for five years. Women with genes for breast cancer should preferably avoid oral contraceptive pills. If 1,000 women use the pill till age 35, by age 45 there will be 11 cases of breast cancer. Importantly, only one of these cases would be extra (pill related), the others would have arisen anyway. Oral contraceptive pills provide significant protection against cancer of the ovaries and uterus. With increasing sexual activity among young people, the benefit to overall health by the use of oral contraceptives far outweighs the possible slight increase of breast cancer.

(The author is a Former Consultant, PGIMER, gynaecologist, infertility specialist and gynae hysteroscopic laparoscopic surgeon based at Chandigarh. You can visit her websites www.endoscopy.co.in for more information & write to her at drnirja@gmail.com)

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