Contraceptives versus Cancer
In another case of why you shouldn’t trust everything you read in the papers, Mr Federico D. Pascual Jr. has written about his stance on the RH bill (anti), and also included an addendum provided by one of his readers about the perils of oral contraceptives:
ABORTIFACIENT: Reader Noel Manalo called our attention to the fact that all contraceptives are abortifacient (causing abortion). He explained in an email:
“The early contraceptives, such as Enovid back in 1957, did prevent ovulation, and therefore conception — majority of the time. But such “hormonal” contraceptives — so called because they used hormones such as estrogen and synthetic hormones like progestin — had a difficult problem.
“They caused internal bleeding and cancer of the uterus. This is the main reason why manufacturers and doctors turned to outright abortifacients (“pampalaglag”).
“The use of abortifacients looks ‘clean.’ The one they abort is the fertilized egg — a human being initially one cell in size, too tiny to see, but a human person nonetheless. Abortifacients murder a helpless, unborn person with the same human worth and dignity as all of us.
“There are still hormonal contraceptives being produced, but they retain the same problems of hormonal contraceptives — intra-uterine bleeding and cancer of the uterus.
“If you take hormonal contraceptives once or a few times, maybe you won’t bleed or get cancer. But for these things to work, you have to take them constantly, day after day, month after month, year after year — until menopause.
“Otherwise, if you miss a dose, you could get pregnant, and all your plans are ruined. This is how people become slaves to contraceptives and abortifacients.”
While I mostly disagree with Mr. Pascual in his views (He argues that good governance is what we need versus population control) I’m not going to take him to task today, and would rather focus on the misinformation that he, via his reader, is spreading through his newspaper. On the issue of contraceptives causing cancer, I did a little bit of research on the google and found this very revealing FAQ from the US National Cancer institute which bases its studies not on hearsay but on factual data. You are free to read the entire FAQ here, but for the purposes of brevity I’d like to highlight key points that overturn the argument that contraceptives cause cancer. In terms of breast cancer:
- A 1996 analysis of worldwide epidemiologic data conducted by the Collaborative Group on Hormonal Factors in Breast Cancer found that women who were current or recent users of birth control pills had a slightly elevated risk of developing breast cancer. The risk was highest for women who started using OCs as teenagers. However, 10 or more years after women stopped using OCs, their risk of developing breast cancer returned to the same level as if they had never used birth control pills…
- The findings of the Women’s Contraceptive and Reproductive Experiences (Women’s CARE) study were in contrast to those described above…The results, which were published in 2002, indicated that current or former use of OCs did not significantly increase the risk of breast cancer. The findings were similar for white and black women. Factors such as longer periods of use, higher doses of estrogen, initiation of OC use before age 20, and OC use by women with a family history of breast cancer were not associated with an increased risk of the disease,
- In a National Cancer Institute (NCI)-sponsored study published in 2003…The results indicated that the risk was highest for women who used OCs within 5 years prior to diagnosis, particularly in the younger group
So in terms of breast cancer, some research indicates a slight risk, especially for women who are younger and have just started using the pill. Other research indicates that they do not increase the risk of breast cancer at all. This is the type of argument that many anti-contraceptive people will use, that the research indicates there is “some” risk. never mind that they inflate it to the black and white statement that they cause cancer unequivocally. To put things into perspective, here are other things that elevate the risk of cancers of all sorts:
- too much red meat and not enough vegetables
- not enough physical activity
- alcoholic drinks
- body fatness (a BMI of between 21-23 is best)
Of course the fact that some research indicates that contraceptives may increase the the risk of cancer should give any woman pause. But the nuance that is lost in reductive statements seen in the newspaper is that there are many things in the world that may increase the chances of cancer, and ultimately it’s up to you to pick and choose what you want. For example, I could never say no to red meat, so I try to complement by eating more vegetables.
On the charges that contraceptives cause ovarian and endometrial cancer, we have the following notes:
- Studies have consistently shown that using OCs reduces the risk of ovarian cancer. In a 1992 analysis of 20 studies of OC use and ovarian cancer, researchers from Harvard Medical School found that the risk of ovarian cancer decreased with increasing duration of OC use. Results showed a 10 to 12 percent decrease in risk after 1 year of use, and approximately a 50 percent decrease after 5 years of use
- The use of OCs has been shown to significantly reduce the risk of endometrial cancer. This protective effect increases with the length of time OCs are used, and continues for many years after a woman stops using OCs
In terms of ovarian and endometrial cancer, the studies are more conclusive. Not only does it not cause cancer, it actually reduces the risks of cancer.
In terms of cervical cancer, there is more information that should give you pause:
- Evidence shows that long-term use of OCs (5 or more years) may be associated with an increased risk of cancer of the cervix (the narrow, lower portion of the uterus) (12). Although OC use may increase the risk of cervical cancer, human papillomavirus (HPV) is recognized as the major cause of this disease.
- In another IARC report, data from eight studies were combined to assess the effect of OC use on cervical cancer risk in HPV-positive women. Researchers found a fourfold increase in risk among women who had used OCs for longer than 5 years. Risk was also increased among women who began using OCs before age 20 and women who had used OCs within the past 5 years (14). The IARC is planning a study to reanalyze all data related to OC use and cervical cancer risk (12).
Here the debate is wide open. There is evidence that contraceptives may be associated with an increased risk of cancer of the cervix, but that HPV is the major cause of the disease. They conclude saying that more research needs to be done to analyze all the data.
Lastly, an interesting tidbit for Filipinas and liver cancer, research shows that “OCs did not increase the risk of liver cancer in Asian and African women, who are considered high risk for this disease. Researchers believe this is because other risk factors, such as hepatitis infection, outweigh the effect of OCs”.
To summarize, let’s go over the risks for different kinds of cancer and introduce a simple rating system (1 being good and 5 being bad) to judge whether or not contraceptives are good or bad for you.
- breast cancer – slight risk (4)
- ovarian and endometrial – reduces risk (1)
- cervical – possibly high risk (4)
- liver – no risk (3)
- average (3)
With an average of three, it would seem that overall contraceptives do not really pose a grave risk to human health, except with the case of cervical cancer. More research needs to be done on this, but the very first precaution a woman must take is to get immunized for the HPV virus, since that is the primary cause of this type of cancer. There are risks involved with taking contraceptives, just as there are risks involved with eating too much red meat. The answer is not to eliminate them out of hand and claim that they cause cancer, but to introduce people to the exact risks they are taking and have them decide for themselves what the best solution is.
