About 140 million women use some form of hormonal contraception , including around 16 million in the United States, but a large Danish study published on Wednesday suggests that, like older pills, they still modestly increase the risk of breast cancer, especially with long-term use.

Here is what the new data and risks should know:

What is the risk?

The overall risk increase was small, which equi It is worth an additional case of breast cancer among the 7,700 women who use such contraceptives per year. d the research says that women must balance the news with the known benefits of the pill, including reducing the risk of other cancers.

The current and recent use of hormonal contraceptives was associated with a 20% increase in the risk of breast cancer. The risk increased with prolonged use, from a 9% increase in risk with less than a year of contraceptive use to 38% after more than 10 years of use.

What about low-dose contraceptives?

Studies of old contraceptive pills have shown "a net benefit to cancer" due to a lower risk of colon, uterus and ovarian cancer despite the increased risk of breast cancer, said Mia Gaudet, cancer epidemiologist Breast of the American Cancer Society.

was optimistic that newer, lower-dose contraceptives would reduce the risk of breast cancer, but these results have frustrated those hopes, said Gaudet, who was not involved in the research.

Is the risk the same for pills, intrauterine devices? patches and implants?

Researchers found a similar risk of breast cancer with the progestin-only intrauterine device, and could not rule out a risk of other hormonal contraceptives such as the patch and the implant. Going deeper, the researchers found no differences between the types of contraceptive pills. Due to the shortage of users, the results for the patch, the vaginal ring, the implant and the progestin injection were less clear, but the analysis did not rule out an increased risk of breast cancer for these methods.

I've been taking these. Should I stop now?

Hormonal contraceptives remain safe and effective, said Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital at Harvard, who was not involved in the research. But 40-year-old women may want to consider non-hormonal IUDs, tie their tubes or talk to their partners about vasectomy.

What are my options?

"Unfortunately, no type of hormonal contraceptive is risk-free," said lead author Lina Morch of Copenhagen University Hospital.

What happens if I have a family history of breast cancer?

Women with a family history of breast cancer may want to consult their doctors about other contraceptives, said Dr. Roshni Rao, a breast surgeon at New York-Presbyterian / Columbia University Medical Center. "Oral contraceptives are like any other medication," Rao said. "There are risks and there are benefits, if you have a reason to take them, it is perfectly reasonable to do so."

How solid is this research?

Researchers analyzed the health records of 1.8 million women, ages 15 to 49, in Denmark, where a national health center The care system allows linking large databases of prescription histories, cancer diagnoses and other information.

The results were published Wednesday in the New England Journal of Medicine. The Novo Nordisk Foundation funded the research, but played no role in the design of the study. The foundation has links with the Danish pharmaceutical company Novo Nordisk, which mainly manufactures drugs for diabetes and does not manufacture contraceptives.

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