Oral contraception and increased bc risk from NEJM's April issue
Estrogens and Breast Cancer http://content.nejm.org/icons/home/spacer.gif http://content.nejm.org/icons/v3_this_article.gif http://content.nejm.org/icons/home/spacer.gifhttp://content.nejm.org/icons/home/spacer.gifhttp://content.nejm.org/icons/v3_arrow_right.gifPDFhttp://content.nejm.org/icons/v3_arrow_right.gifPDA Full Texthttp://content.nejm.org/icons/home/spacer.gifhttp://content.nejm.org/icons/home/spacer.gif http://content.nejm.org/icons/v3_tools_service.gif http://content.nejm.org/icons/home/spacer.gifhttp://content.nejm.org/icons/home/spacer.gifhttp://content.nejm.org/icons/v3_arrow_right.gifAdd to Personal Archivehttp://content.nejm.org/icons/v3_arrow_right.gifAdd to Citation Managerhttp://content.nejm.org/icons/v3_arrow_right.gifNotify a Friendhttp://content.nejm.org/icons/v3_arrow_right.gifE-mail When Citedhttp://content.nejm.org/icons/v3_arrow_right.gifE-mail When Letters Appearhttp://content.nejm.org/icons/home/spacer.gifhttp://content.nejm.org/icons/home/spacer.gif http://content.nejm.org/icons/v3_more_information.gif http://content.nejm.org/icons/home/spacer.gifhttp://content.nejm.org/icons/home/spacer.gifhttp://content.nejm.org/icons/v3_arrow_right.gifRelated Articlehttp://content.nejm.org/icons/spacer.gifhttp://content.nejm.org/icons/spacer.gifby Yager, J. D.</B></FONT>http://content.nejm.org/icons/v3_arrow_right.gifFind Similar Articleshttp://content.nejm.org/icons/v3_arrow_right.gifPubMed Citationhttp://content.nejm.org/icons/home/spacer.gifTo the Editor: Yager and Davidson (Jan. 19 issue)1 state unequivocally that the use of oral contraceptives is associated with an increased risk of breast cancer. This view is not supported by an article that appeared in the Journal in 20022 and in the accompanying editorial.3 In light of this recent information, I hope that the authors will modify their conclusions. Charles L. Blander, M.D. North Shore Medical Center Salem, MA 01970 cblander@blandermd.com References
The authors reply: Dr. Blander is concerned that recent data do not support our statement that the use of oral contraceptives is associated with a small but significant risk of breast cancer. Our conclusion rests on the 1996 meta-analysis of oral-contraceptive use and breast cancer.1 We agree that results reported by Marchbanks et al., which received a favorable comment from one of us,2 did not support this association. However, the conclusion from the study by Marchbanks et al. must be tempered by the subsequent report by Kumle et al.,3 which described a prospective study of more than 100,000 women between the ages of 30 and 49 years at the time of enrollment. It demonstrated that current or recent use of oral contraceptives is associated with an increased risk of breast cancer. For this reason, we continue to believe that the totality of the evidence suggests a small but real increase in the risk of breast cancer for current users. Of course, this small absolute risk must be considered in the context of the numerous health benefits that oral-contraceptive use affords to so many young women. James D. Yager, Ph.D. Johns Hopkins Bloomberg School of Public Health Baltimore, MD 21205 jyager@jhsph.edu |
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