The Birth Control Pill and Breast Cancer Risk

Medically Reviewed by Traci C. Johnson, MD on July 12, 2023
4 min read

Since the early 1960s, birth control pills have become the most popular and one of the most effective forms of birth control used in the U.S. But an association between estrogen and an increased risk of breast cancer has led to a continuing debate about the role birth control pills may play in developing breast cancer.

For most women, especially young women, experts say the benefits of birth control pills far outweigh the risk. But here are some frequently asked questions and answers about the controversy.

Talk to your doctor about your best birth control options. If you choose to avoid hormonal birth control, there are nonhormonal options including the copper IUD, contraceptive gel, and multiple barrier methods.

Maybe. Studies that have examined the use of oral contraceptives as a risk factor for breast cancer have produced conflicting results. Some researchers think this might be due to the fact that the level of hormones in birth control pills has changed since they were first studied. Early birth control pills contained much higher levels of hormones than today's low-dose pills and posed a higher risk.

Scandinavian researchers have noted an increase in breast cancer in a group of women that were currently taking or had recently taken birth control pills. Longer use of the pill seemed to increase the risk. Similar research found that 10 years or more after women stopped using birth control pills, their breast cancer risk returned to the same level as if they had never used birth control pills.

However, another reputable study by Women's Contraceptive and Reproductive Experience (Women's CARE) done between 1994 and 1998 showed there was no increased risk of breast cancer in current or former users of birth control pills.

In general, most studies have not found an overall increased risk of breast cancer due to the use of oral contraceptives.

Maybe. A study published in the Journal of the American Medical Association found that women with a strong family history of breast cancer may have up to an 11 times higher risk of breast cancer if they have ever taken the pill. But experts caution that the study involved mainly women who took birth control pills prior to 1975, when it contained much higher levels of the hormones estrogen and progestin than today's lower-dose pill.

Those with a family history of breast cancer related to mutations in the BRCA genes should use caution before taking birth control pills. Families at increased risk of breast cancer who are carriers of alterations in these genes may further increase their risk of breast cancer by taking birth control pills. Recent studies show taking birth control pills did not increase the risk in women who are carriers of the abnormal form of the BRCA2 gene, but did in those with the altered BRCA1 gene.

Women should discuss their family history of cancer with their doctor when evaluating the risks and benefits of using birth control pills.

Yes, according to the latest research. A study of more than 100,000 women suggests that the increased breast cancer risk associated with birth control pills is highest among older women. The study found that the risk of breast cancer was greatest among women aged 45 and over who were still using the pill. This group of women was nearly one-and-a-half times as likely to get breast cancer as women who had never used the pill.

But experts caution that many of the women were using older birth control pills that contained higher doses of hormones. Today's lower-dose birth control pills are thought to reduce this risk.

Yes. The pill's protective effect against ovarian cancer has been well documented. Ovarian cancer risk is reduced by as much as 30%-50% among women taking birth control pills for at least three years. New studies show that as little as 6 months of use can dramatically reduce the risk of ovarian cancer. That protective effect increases the longer a woman is on the pill.

There was also a reduced incidence of endometrial cancer.

And a new study suggests oral contraceptives may also reduce the risk of colorectal cancers. The European study found that women who had ever used birth control pills were about 20% less likely to develop colorectal cancers than women who had never used the pills. The reduced risk was great even if the woman had used the pills recently.