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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Fältnamn	Indikatorer	Metadata
000		04754naa a2200481 4500
001		oai:DiVA.org:uu-484754
003		SwePub
008		220916s2022 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
009		oai:prod.swepub.kib.ki.se:154365564
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4847542 URI
024	7	a https://doi.org/10.1016/j.lanepe.2022.1004702 DOI
024	7	a http://kipublications.ki.se/Default.aspx?queryparsed=id:1543655642 URI
040		a (SwePub)uud (SwePub)ki
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Niemeyer Hultstrand, Jennyu Uppsala universitet,Reproduktiv hälsa4 aut0 (Swepub:uu)jenhu146
245	1 0	a Hormonal contraception and risk of breast cancer and breast cancer in situ among Swedish women 15-34 years of age :b A nationwide register-based study
264	1	b Elsevier,c 2022
338		a electronic2 rdacarrier
520		a 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.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Cancer och onkologi0 (SwePub)302032 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cancer and Oncology0 (SwePub)302032 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Hälsovetenskapx Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi0 (SwePub)303022 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Health Sciencesx Public Health, Global Health, Social Medicine and Epidemiology0 (SwePub)303022 hsv//eng
653		a Hormonal contraception
653		a Progestagen
653		a Progestagen-only contraception
653		a Breast cancer
653		a Population-based
700	1	a Gemzell-Danielsson, Kristinau Karolinska Institutet4 aut
700	1	a Kallner, Helena Koppu Karolinska Institutet4 aut
700	1	a Lindman, Henriku Uppsala universitet,Experimentell och klinisk onkologi4 aut0 (Swepub:uu)henrlind
700	1	a Wikman, Peru Uppsala universitet,Perinatal, neonatal och barnkardiologisk forskning4 aut0 (Swepub:uu)perwi708
700	1	a Sundström Poromaa, Inger,d 1964-u Uppsala universitet,Reproduktiv hälsa4 aut0 (Swepub:uu)inspo702
710	2	a Uppsala universitetb Reproduktiv hälsa4 org
773	0	t The Lancet Regional Healthd : Elsevierg 21q 21x 2666-7762
856	4	u https://doi.org/10.1016/j.lanepe.2022.100470y Fulltext
856	4	u https://uu.diva-portal.org/smash/get/diva2:1696410/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-484754
856	4 8	u https://doi.org/10.1016/j.lanepe.2022.100470
856	4 8	u http://kipublications.ki.se/Default.aspx?queryparsed=id:154365564

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