Why isn't this study about the pill and breast cancer heeded?

By Dennis Byrne

Chicago Tribune

Not wanting to become known as the town quack, I am reluctant to write another politically incorrect column about breast cancer.

Four weeks ago, when I reported a study that found a statistical link between abortion and breast cancer, the hate e-mail poured in, denouncing me for being an ignorant, stupid, anti-science, anti-choice and anti-woman lunatic. But it also brought a message alerting me to yet another study, suggesting that premenopausal women (younger than 50) who used oral contraceptives prior to having their first child faced a higher risk of breast cancer. Yes, I know, this debate has been going on for years, if not decades, and judging by the last studies given wide exposure a few years ago by the media, the issue seems settled: Oral contraception does not significantly increase the risk of breast cancer.

There's just one problem. According to an analysis in one of the most credible peer-reviewed journals in the country, the Mayo Clinic Proceedings, the risk is real. The study employed an often-used medical research technique called "meta-analysis" that allows researchers to combine data from other studies on the risk to get a larger picture. The result: Premenopausal women who used oral contraceptives prior to having their first child have a 44 percent higher chance of getting cancer than women who didn't use the pill. If they used the pill for more than four years prior to their first full-term pregnancy, the risk increased 52 percent. Chris Kahlenborn, an internist at the Altoona (Pa.) Hospital and the study's lead author, suggests one additional woman in 200 could get breast cancer. Extrapolated throughout the population, that could mean thousands more cases every year. I'd say that's an important story.

The reaction? Nearly total silence. Since it was published more than a year ago, I couldn't find a single reference to it in the archives of the New York Times, Washington Post, Los Angeles Times or this paper. The Associated Press appears not to have covered it. I couldn't find a single mainstream media article about it in a Google search. But stories about other breast cancer risks were plentiful, including one about how sleeping with a night light on can increase your chances of getting breast cancer. The National Institute of Cancer doesn't mention the study on its Web site, but it did detail a 5-year-old study claiming to find no higher risk to pill use. The American Cancer Society also doesn't mention the study and concedes only that "it is still not clear what part" the pill plays in breast cancer. Such guidance, if not deceptive, is certainly incomplete.

"The last word seems to be that the pill is safe," Kahlenborn told me, as he called me with his frustration with being unable to get this important information out to women. "The word basically in the medical community before the study, and it continues to be, is that the pill is quite safe." But the results of his study are disquieting enough that if the pill were just coming out today, the findings would be enough for the Food and Drug Administration to keep it off the market, he said.

Why so little attention? My guess is that the pill has been so widely accepted, that it has become such a key part of feminist ideology and that the pharmaceutical companies make so much from it, that few folks are willing at this stage to talk about its dangers. It's no small irony that those who habitually are quick to criticize big business and government for failing to "do enough" to protect consumers are mostly silent when it comes to talking about this particular risk.

Here, I also should clarify some things to all the folks who are itching to hit the "post comment" button: Kahlenborn is pro-life, but what has that to do with his research? As for me, I am not opposed to contraception, oral or otherwise. I am not plotting to get the pill banned. I am not writing this column for hidden religious reasons. I am not saying that the Kahlenborn study is the last word; I'm not a scientist, so I can't vouch for its methodology or conclusions. Just like the abortion/breast cancer study, I'm writing about it because people have a right to know about the existence of health information, even if it is contradictory to the given wisdom.

The truth is that I'd just as soon not write about it, for all the heat it generates. I just wish that someone else would.