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A Prospective Cohort Study

Robert J. Lipnick, DSc; Julie E. Buring, DSc; Charles H. Hennekens, MD; Bernard Rosner, PhD; Walter Willett, MD; Christopher Bain, MB, BS; Meir J. Stampfer, MD; Graham A. Colditz, MB, BS; Richard Peto, MSc; Frank E. Speizer, MD

JAMA. 1986;255(1):58-61.

Abstract
In 1976, information on oral contraceptive (OC) use as well as numerous risk factors for breast cancer was provided by 121,964 married female registered nurses aged 30 to 55 years. Ninety-two percent of women in the cohort completed follow-up questionnaires, and vital records were systematically searched to ascertain deaths among nonrespondents. After four years of follow-up, 592 incident cases of breast cancer were identified. Compared with never users, the age-adjusted relative risk (RR) of breast cancer, regardless of menopausal status, among all women who had ever used OCs was 1.0. Among premenopausal women compared with those who had never used OCs, the RR of breast cancer was 1.5 for current use of OCs in 1976 and 1.0 for past use. Among postmenopausal women, the RR for past use of OCs was 1.0. These estimates were essentially unaltered after controlling for other known risk factors for breast cancer in multiple logistic regression analysis. Furthermore, there was no modification of these effects by family history of breast cancer, age at first use, timing of the first birth, or other breast cancer risk factors. Data on past use of OCs provide substantial reassuring evidence that there is no large excess risk of breast cancer within a few years of cessation of pill use. The observed moderate elevation of breast cancer risk with current use was of borderline statistical significance. However, the observation was based on 29 cases and may reflect the effect of sampling variability, as most other studies have not observed a relationship between current use of OCs and breast cancer in women of this age.

(JAMA 1986;255:58-61)

Author Affiliations
From the Channing Laboratory (Drs Lipnick, Buring, Hennekens, Rcsner, Willett, Bain, Stampfer, Colditz, and Speizer) and the Department of Medicine (Drs Lipnick, Hennekens, Stampfer, Colditz, and Speizer), Brigham and Women's Hospital, the Departments of Preventive Medicine and Clinical Epidemiology (Drs Buring, Hennekens, and Rosner), Harvard Medical School, and the Department of Epidemiology, Harvard School of Public Health (Dr Willett), Boston; and the Radcliffe Infirmary, Oxford, England (Mr Peto). Dr Bain is currently with the University of Queensland, Australia.

Footnotes
Reprint requests to 180 Longwood Ave, Boston, MA 02115 (Dr Speizer).

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