Hormonal contraception and risk of breast cancer and breast cancer in situ among Swedish women 15-34 years of age: A nationwide register-based study

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Niemeyer Hultstrand, JennyUppsala universitet,Reproduktiv hälsa (author)

Hormonal contraception and risk of breast cancer and breast cancer in situ among Swedish women 15-34 years of age : A nationwide register-based study

Article/chapterEnglish2022

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Elsevier,2022
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LIBRIS-ID:oai:DiVA.org:uu-484754
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-484754URI
https://doi.org/10.1016/j.lanepe.2022.100470DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:154365564URI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Background: Evidence on a possible association between newer hormonal contraceptives (HC) and risk of breast cancer remains inconclusive, especially as concerns progestogen-only methods.Methods: In this nationwide prospective cohort study, all Swedish women aged 15-34 at study start on January 1st 2005, or who turned 15 years during the study period, were followed until December 31st 2017. Using information from seven National Registers, we assessed the risk ratio of developing breast cancer and breast cancer in situ in relation to different HC using Poisson regression. We adjusted the analyses for several known confounders of breast cancer.Findings: This cohort included 1.5 million women providing more than 14 million person-years. During the study period, 3842 women were diagnosed with breast cancer. Compared with never users of any HC, we found no increased risk of developing breast cancer among current users of any combined HC, IRR 1.03 (0.91-1.16), whereas current users of progestogen-only methods had an increased risk of developing breast cancer, IRR 1.32 (1.20-1.45). Across all types of HC, the risk of developing breast cancer appeared to be highest the first five years of use (combined HC IRR 1.39 (1.14-1.69); progestogen-only methods IRR 1.74 (1.44-2.10). The risk disappeared ten years after the women stopped using HC. The absolute risk of breast cancer per 100,000 women-years was 22.4 for never users, 10.9 for current users of combined HC, and 29.8 for current users of progestogen-only methods.Interpretation: Current use of progestogen-only methods is associated with a small increased risk of developing breast cancer, whereas we could only detect an increased risk among users of combined HC during the first five years of use. This may partly be explained by a selective prescription of progestogen-only methods to women with risk factors for breast cancer, like smoking or obesity. As the absolute risk of breast cancer was small, the many health benefits associated with HC must also be taken into account in contraceptive counselling.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Public Health, Global Health, Social Medicine and Epidemiology hsv//eng
Hormonal contraception
Progestagen
Progestagen-only contraception
Breast cancer
Population-based

Added entries (persons, corporate bodies, meetings, titles ...)

Gemzell-Danielsson, KristinaKarolinska Institutet (author)
Kallner, Helena KoppKarolinska Institutet (author)
Lindman, HenrikUppsala universitet,Experimentell och klinisk onkologi(Swepub:uu)henrlind (author)
Wikman, PerUppsala universitet,Perinatal, neonatal och barnkardiologisk forskning(Swepub:uu)perwi708 (author)
Sundström Poromaa, Inger,1964-Uppsala universitet,Reproduktiv hälsa(Swepub:uu)inspo702 (author)
Uppsala universitetReproduktiv hälsa (creator_code:org_t)

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In:The Lancet Regional Health: Elsevier212666-7762

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