A PROSPECTIVE-STUDY OF ORAL-CONTRACEPTIVE USE AND RISK OF BREAST-CANCER (NURSES HEALTH STUDY, UNITED-STATES)

Results of previous epidemiologic studies have provided reassurance th at there is little, if any, increase in risk of breast cancer with ora l contraceptive (OC) use in general. However, in several studies, an i ncreased risk of breast cancer has been observed in two subgroups, you ng women who used OCs for extended durations and in women who used OCs prior to a first-term pregnancy. We evaluated these relationships usi ng data from the ongoing Nurses' Health Study cohort (United States), We documented 3,383 cases of breast cancer from 1976 to 1992 among 1.6 million person-years of follow-up. We observed no overall relationshi p between duration of OC use and breast cancer risk, even among women who reported using OCs for 10 or more years (multivariate relative ris k [RR] = 1.11, 95 percent confidence interval [CI] = 0.94-1.32). Among women less than 45 years of age, the multivariate RR for using OCs fo r 10 or more years was 1.07 (CI = 0.70-1.65) compared with never-users . The risk associated with five or more years of OC use prior to a fir st full-term pregnancy compared with never-use was 0.96 (CI = 0.65-1.4 3). Among women less than 45 years of age, we observed no evidence of an increased risk with OC use before a first full-term pregnancy (use for five or more years: RR = 0.57, CI = 0.24-1.31). Because of the age distribution of our cohort, we were unable to evaluate these relation ships among women less than 40 years of age. Our study provides consid erable evidence that long-term past OC use, either overall or prior to a first full-term pregnancy, does not result in any appreciable incre ase in breast cancer risk in women over 40 years of age.