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Absence of an effect of injectable and implantable progestin-only contraceptives on subsequent risk of breast cancer.
Contraception. 2004 May; 69(5):353-60.C

Abstract

Animal data indicate that both estrogens and progestins could be carcinogenic and that progestins could serve as tumor promoters. Human studies have not confirmed an increased risk of breast cancer from long-term use of oral contraceptives, but have shown an increased risk from hormone replacement therapy including progestins. The present study analyzed the relationship between breast cancer and use of injectable and implantable progestin-only contraceptives. Analyses were performed on data collected in a population-based, multicenter, case-control study, the Women's Contraceptive and Reproductive Experiences Study of the National Institute of Child Health and Human Development. The study involved 4575 randomly sampled cases with invasive breast cancer diagnosed between 1994 and 1998, and 4682 controls, identified using random digit dialing. We assessed the association between exposure to injectable contraceptives and risk of breast cancer. The use of injectable contraceptives was not associated with an increased risk of breast cancer [odds ratio (OR) = 0.9, 95% confidence interval (CI): 0.7, 1.2]. Risk was not increased among current users, defined as women who used injectable contraceptives within 1 year of the reference date (OR = 0.7, 95% CI: 0.4, 1.3) or those who initiated use in the 5 years immediately preceding the reference date (OR = 0.9, 95% CI: 0.5, 1.4), or with use beginning before age 35 (OR = 0.9, 95% CI: 0.6, 1.3). Among users, risk increased with increasing duration of use (p = 0.03). However, short-term users (<6 months duration) were at decreased risk relative to never users (OR = 0.6, 95% CI: 0.4, 1.0). When the short-term users were then excluded from the duration-response analysis, the slope of the duration-response became slightly (and nonsignificantly) negative. Risk was not increased among women with 24 or more months of use relative to never users (OR = 1.4, 95% CI: 0.8, 2.5). No increased risk was seen from implantable contraceptives either, although the sample sizes were small. This study does not support an increased risk of breast cancer associated with the use of injectable or implantable progestin-only contraceptives in women aged 35 to 64.

Authors+Show Affiliations

Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, 824 Blockley Hall, 423 Guardian Drive, University of Pennsylvania, Philadelphia, PA 19104-6021, USA. bstrom@cceb.med.upenn.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15105056

Citation

Strom, Brian L., et al. "Absence of an Effect of Injectable and Implantable Progestin-only Contraceptives On Subsequent Risk of Breast Cancer." Contraception, vol. 69, no. 5, 2004, pp. 353-60.
Strom BL, Berlin JA, Weber AL, et al. Absence of an effect of injectable and implantable progestin-only contraceptives on subsequent risk of breast cancer. Contraception. 2004;69(5):353-60.
Strom, B. L., Berlin, J. A., Weber, A. L., Norman, S. A., Bernstein, L., Burkman, R. T., Daling, J. R., Deapen, D., Folger, S. G., Malone, K. E., Marchbanks, P. A., Simon, M. S., Ursin, G., Weiss, L. K., & Spirtas, R. (2004). Absence of an effect of injectable and implantable progestin-only contraceptives on subsequent risk of breast cancer. Contraception, 69(5), 353-60.
Strom BL, et al. Absence of an Effect of Injectable and Implantable Progestin-only Contraceptives On Subsequent Risk of Breast Cancer. Contraception. 2004;69(5):353-60. PubMed PMID: 15105056.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Absence of an effect of injectable and implantable progestin-only contraceptives on subsequent risk of breast cancer. AU - Strom,Brian L, AU - Berlin,Jesse A, AU - Weber,Anita L, AU - Norman,Sandra A, AU - Bernstein,Leslie, AU - Burkman,Ronald T, AU - Daling,Janet R, AU - Deapen,Dennis, AU - Folger,Suzanne G, AU - Malone,Kathleen E, AU - Marchbanks,Polly A, AU - Simon,Michael S, AU - Ursin,Giske, AU - Weiss,Linda K, AU - Spirtas,Robert, PY - 2003/12/02/received PY - 2003/12/30/revised PY - 2003/12/30/accepted PY - 2004/4/24/pubmed PY - 2004/8/13/medline PY - 2004/4/24/entrez SP - 353 EP - 60 JF - Contraception JO - Contraception VL - 69 IS - 5 N2 - Animal data indicate that both estrogens and progestins could be carcinogenic and that progestins could serve as tumor promoters. Human studies have not confirmed an increased risk of breast cancer from long-term use of oral contraceptives, but have shown an increased risk from hormone replacement therapy including progestins. The present study analyzed the relationship between breast cancer and use of injectable and implantable progestin-only contraceptives. Analyses were performed on data collected in a population-based, multicenter, case-control study, the Women's Contraceptive and Reproductive Experiences Study of the National Institute of Child Health and Human Development. The study involved 4575 randomly sampled cases with invasive breast cancer diagnosed between 1994 and 1998, and 4682 controls, identified using random digit dialing. We assessed the association between exposure to injectable contraceptives and risk of breast cancer. The use of injectable contraceptives was not associated with an increased risk of breast cancer [odds ratio (OR) = 0.9, 95% confidence interval (CI): 0.7, 1.2]. Risk was not increased among current users, defined as women who used injectable contraceptives within 1 year of the reference date (OR = 0.7, 95% CI: 0.4, 1.3) or those who initiated use in the 5 years immediately preceding the reference date (OR = 0.9, 95% CI: 0.5, 1.4), or with use beginning before age 35 (OR = 0.9, 95% CI: 0.6, 1.3). Among users, risk increased with increasing duration of use (p = 0.03). However, short-term users (<6 months duration) were at decreased risk relative to never users (OR = 0.6, 95% CI: 0.4, 1.0). When the short-term users were then excluded from the duration-response analysis, the slope of the duration-response became slightly (and nonsignificantly) negative. Risk was not increased among women with 24 or more months of use relative to never users (OR = 1.4, 95% CI: 0.8, 2.5). No increased risk was seen from implantable contraceptives either, although the sample sizes were small. This study does not support an increased risk of breast cancer associated with the use of injectable or implantable progestin-only contraceptives in women aged 35 to 64. SN - 0010-7824 UR - https://www.unboundmedicine.com/medline/citation/15105056/Absence_of_an_effect_of_injectable_and_implantable_progestin_only_contraceptives_on_subsequent_risk_of_breast_cancer_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0010782404000204 DB - PRIME DP - Unbound Medicine ER -