NOT a week goes by it seems without another piece of research linking hormonal birth control use to cancer. Last week we saw high estrogen birth control pills linked to increased risk of breast cancer development. The burden of relating this information to women generally falls to those with little background in reading scientific research and with little time to process the information. While the specific findings of the research will vary, what is certain is that particular points will always be made within the scope of the coverage and those points can sometimes be more confusing for the reader than the research itself.
As women we will be told that the findings reported do not mean we should stop taking the Pill and that, overall, the benefits outweigh any risks. It will be made clear that the absolute risk for breast cancer (or any other cancer) is very low. The coverage will conclude by relating that the birth control pill definitely lowers the risk of ovarian and endometrial cancers.
As the Atlantic’s Olga Khazan pointed out, despite breast cancer being often cited as one of the biggest killers of women, the Pill remains throughout the appearance of new research still a very popular method of contraception.
Jenny Kutner over at Salon wrote the story that had this headline, ‘Please do not freak out about birth control being linked to breast cancer.’ She noted that she was in agreement with the take of Jezebel writer Erin Gloria Ryan, and her story with the headline ‘Birth Control Has Been Linked To Breast Cancer, But Don’t Freak Out.’ Erin’s main concerns were that women should not come off the pill in fear and become pregnant, as well as acknowledging that this information should not be used by others to push an agenda: “Prepare for this factoid to be splashed, sans nuance, on all sorts of whackadoodle political propaganda soon!”
But is there a lack of nuance and, yes, some propaganda, in this coverage with its go-to statements from the Atlantic, Salon, Jezebel and many of the other outlets where many women see this kind of news? Do those outlets also have an agenda?
I spoke with Salon writer Jenny Kutner to ask how she tackled relating this research and she admitted to a certain biased stance: “I guess you could say I’m concerned with keeping coverage overall balanced, in addition to making my own coverage fair,” she explained. “But I do work for a site with a specific political slant and I openly identify as a feminist writer, so coverage of things like birth control will always be presented through that lens. When I, personally, see something that says birth control pills can increase the risk of breast cancer, I don’t really want it to be true.”
Take a look at the information available online from any of the national cancer awareness and prevention organizations and you will find that research has shown that the birth control pill increases risk of breast and cervical cancer. Prolonged use – especially starting at an early age, as many women now do – will increase the risk further. 1 in 8 women will get breast cancer in their lifetime. The chance that breast cancer will be responsible for a woman’s death is 1 in 36. It is the primary cause of cancer-related death in women. Rates have been decreasing, partly it is believed, due on less women using that other synthetic hormone treatment – HRT – which was shown by the independent organization the Women’s Health Initiative some years back to increase breast cancer risk.
Cervical cancer is less common than it was previously, mainly as a result of an increase in Pap smears. We currently hear of it being combated with the HPV vaccine. However, what is often not mentioned is that a woman with HPV can combat and rid herself of the virus if she has a strong immune system. The Pill, with its affect of suppressing the immune system, can actually make it more likely that the HPV will develop to cancer. In fact, long-term use of the Pill significantly increases your risk of contracting cervical cancer.
Ovarian cancer is much more rare than breast cancer and cervical cancer, although early detection is not as simple. 1 in 72 women will get ovarian cancer and the lifetime chance of dying from this disease is 1 in 100. 3% of women in the US will develop endometrial cancer at some point during their lives, making it more common, but still less common than breast cancer. Both cancers predominantly affect post-menopausal women.
Despite all of this – an increase in cancer risk due to the Pill tends to be presented as a complex issue, whereas a decrease in cancer risk due to the Pill is presented as simple and clear, when obviously this would be quite complex too.
A pregnancy through to birth also lowers a woman’s risk of contracting ovarian and endometriol cancer, with multiple pregnancies starting at a young age further lowering that risk. Breastfeeding, especially for a least a year, reduces the risk of a woman getting breast cancer. Early pregnancy, that is before you reach 30, and multiple pregnancies also decrease breast cancer risk. A woman who has a baby after 30 is at higher risk of breast cancer than a woman who has never had a baby.
Jezebel’s Erin Gloria Ryan stated in her coverage: “And, you know, not using birth control pills carries a pretty significant risk of pregnancy, another medical condition that seriously injures or kills millions of women globally per year.” As we’re talking cancer, it would have been more appropriate to cite the above information.
Women are encouraged to stay on the Pill to avoid pregnancy (despite the alternative methods available for pregnancy prevention) and to take seriously its positive potential to decrease their risk of ovarian and endometrial cancers when deciding whether to continue using it. But, they are not often encouraged, particularly in fact by these media outlets, to get pregnant in their early twenties, have more than one child, or breastfeed for a year – not for the good of their own health.
Surely much of our individual risk for contracting cancer is related to the context in which we live our lives. For example, I often wonder if it is taken into account that it tends to be richer, whiter women who use the Pill. There might be something else about women who use birth control pills that make them less susceptible to some cancers. The women studied are not living in a box when the study is conducted, and even if they were, what would the box be made from? Even that would impact cancer risk. It might be that they weigh less, workout more, or eat more healthily.
Should we not also be made aware when discussing cancer risk that lifestyle changes have been shown to have the potential to prevent around 40-50% of the most common cancers? Some of the causal factors that were studied to draw this conclusion included smoking habits, diet including consumption of red meat, processed foods, fruit and vegetables, fiber and salt, weight, physical exercise, use of alcohol, occupation, use of hormone replacement therapy, and again, whether you choose to breastfeed.
Pill “scares,” as they’re often called, have been linked in the past to an increase in unplanned pregnancies, and as such abortions. This is the real implication of the pleading for women to “not freak out” when new research is revealed. Writing on this matter tends to concentrate on the increased cost to society, economically speaking, when women decide to stop taking the Pill. This is one of the reasons that the specific issues with newer and popular Pill brands like Yaz, Yasmin and Beyaz and newer and popular devices like the NuvaRing have been little discussed in the media and what discussion there has been is often met with similar “don’t freak out the women” anger mixed with concern.
In my mind, we should discuss the potential health hazards of using the birth control pill, but we should also talk about how to prevent pregnancy effectively without the Pill. What has caused an increase in unplanned pregnancies and abortions in the past is not the Pill “scare” itself (is any discussion of a danger whatsoever a “scare”?), but the lack of knowledge of and access to other contraceptive options. Women should be free to decide to stop taking the Pill and not think their only alternative is pregnancy.
Women already do stop taking the Pill as a result of their experience of side effects, more often without any new research in the media to prompt them to do so. Half of all women using the Pill stop taking it after one year of use. So, clearly there’s a huge need for a discussion of alternatives.
Just as we as individuals have a context that impacts our cancer risk, so too does scientific research have a context that bares serious consideration.
In response to a discussion of some of the other side effects of the birth control pill, Alice Hoyle wrote, “All science occurs under patriarchal capitalist conditions. We like to think science is objective but it simply can never be due to these forces. We can try, but the fact of the matter is pharmaceutical companies have vested interests in favorable research, female research and researchers are much more likely to be marginalized (and no I don’t think “double blind peer review” is enough to ensure female led research has an equal footing to male led research). Female voices and experiences are continually erased throughout history and in life and this is also true in science.”
Next time you see new research on the Pill, keep in mind that it is part of a billion dollar industry and that evidence suggests a wider investment in women remaining avid pill users. If you decide you’d rather not take your chances, then research the alternatives and get body literate. Don’t be scared into staying on!