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No Evidence of a Latent Effect

James J. Schlesselman, PhD; Bruce V. Stadel, MD, MPH; Pamela Murray, MS; Shenghan Lai, PhD

JAMA. 1988;259(12):1828-1833.

Abstract
A long-term latent effect of oral contraceptives (OCs) on breast cancer risk has been suggested as an explanation for some studies' failure to detect an association between OCs and breast cancer. To address this latency hypothesis, we analyzed data on 4714 case subjects and 4540 control subjects from the population-based Cancer and Steroid Hormone Study. No support was evident for a latent effect of OCs on breast cancer risk through age 54 years: among parous women who had cumulated more than six years of OC use before their first term pregnancy, the risk of breast cancer, relative to nonusers before first term pregnancy, was 0.6 at zero to four years after first term pregnancy (95% confidence interval [CI], 0.2 to 1.8), 0.7 at five to nine years (95% CI, 0.3 to 1.7), and 1.1 at ten to 14 years (95% CI, 0.3 to 3.9). Among nulliparous women with more than six years of OC use in total, the relative risk of breast cancer, by interval from last use of OCs, was 1.3 at zero to four years (95% Cl, 0.8 to 2.0), 1.1 at five to nine years (95% CI, 0.5 to 2.0), and 0.6 at ten to 14 years (95% CI, 0.1 to 3.7).

(JAMA 1988;259:1828-1833)

Author Affiliations
From the Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, Md (Drs Schlesselman, Murray, and Lai); and Contraceptive Evaluation Branch, Center for Population Research, National Institute of Child Health and Human Development, Bethesda, Md (Dr Stadel).

Footnotes
Reprint requests to Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814 (Dr Schlesselman).

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JAMA 1988;260:1240-1241.
ABSTRACT