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November 7, 1986

Breast Cancer and the Use of Oral Contraceptives

Author Affiliations

University of Nebraska Medical Center
Creighton University School of Medicine Omaha

JAMA. 1986;256(17):2346. doi:10.1001/jama.1986.03380170062018

To the Editor.—  The report of Lipnick et al1 on breast cancer incidence and contraceptive use in 70 151 premenopausal nurses showed that the majority of younger women (aged <39 years) with cancer had used contraceptives. Age-specific annual breast cancer incidence calculated from their Table 4 was significantly increased in these age groups, compared with US white females reported by the National Cancer Institute2 (Table). In such a large population sample, one might expect that some of the confounding variables that increase the risk of breast cancer, such as genetic predisposition or benign breast disease, would not have undergone positive selection bias.In another recent report using the same data base, Pathak et al3 found that low parity increased the risk of breast cancer compared with nulliparous nurses; with increasing parity of three or more pregnancies (nurses aged >39 years), the risks became similar for the childless