The World Health Organization added "it" to an official list of known carcinogens in 2005. The Physicians' Desk Reference cited a link between it and breast cancer in 2006. Quietly, word is getting out, just not quickly enough for young women. They are being told in doctor's offices that it is safe.
It is the pill, the oral contraceptive that over 80% of women have been on at some point in their lives. For most women, oral contraceptives seem to cause only small negative side effects. But the verdict on a link to cancer -- in particular, breast cancer --is coming in, and it is worrisome.
Results of a meta-analysis conducted by Dr. Chris Kahlenborn, a Pennsylvania-based internist, show that being on the pill at a young age, before having children, increases the chance of developing breast cancer by an average of 44%. This is hardly the stuff of "junk science": Dr. Kahlenborn's work was published late last year in the peer-reviewed journal of the world-renowned Mayo Clinic.
This week, he visited Ottawa to discuss his astounding findings. You'd think most women would know about his study. They don't.
To listen to Dr. Kahlenborn's critics, one would think he had self-published his work on YouTube after consulting with a mystic. Doctors dismiss it and much of the media ignores it. One reporter from CITY-TV, calling to ask about Dr. Kahlenborn's presentation in Ottawa, led the interview with the question: "Don't you just want to stop women from having sex?" Nothing could be further from the truth.
Yet such skepticism is understandable given that the Canadian Cancer Society itself is dismissive. The group's Web site notes: "Alcohol, as well as the use of oral contraceptives (the pill) are associated with a slight increase in breast cancer risk." One might infer that taking the pill is about as risky as having a beer after work. And since no one is giving up the latter, why care about the former?
The Canadian Society of Obstetricians and Gynecologists, too, downplays the link. "The risk for premenopausal breast cancer is slightly increased in oral contraceptive users," the group notes. "Compared to other reproductive and lifestyle factors that affect breast cancer risk, the increase in risk associated with the oral contraceptive is very small."
We read stories about links between breast cancer and red meat; between breast cancer and light exposure; between breast cancer and toxins in the environment; and, most recently, between cancer and BBQs. So why the silence on this link?
A couple of plausible reasons: One is simple inertia. Acknowledging this study means rethinking the pill as, say, a casually prescribed acne medication. Others might see dissemination of this health information as an indirect form of blaming the victim -- an attempt to judge women and tell them they caused their own cancer.
Still others attack the messenger: They pounce on any hint that some of the people spreading warnings about the pill happen to be religious Christians --as if that fact somehow served to taint the latest peer-reviewed research in the area. These critics don't see the pill-breast cancer link as a women's health issue, but rather as a conspiracy by religious types to limit women's sex lives.
Some players in the pharmaceutical industry are eager to promote this stereotype. Pharmaceuticals manufacturers obviously have a vested interest in concealing the negative side effects of the pill. Imagine the profits that arise from a prescription drug that almost half the population goes on for years of their lives. (Indeed, the target market starts well before adulthood: Alesse, made by Wyeth Canada, is a birth control pill for kids age 14 and up.)
One stark fact should help us cut through the spin: A woman's lifetime risk of breast cancer has risen -- from one in 22 in the 1940s to about one in eight today.
Something is going on with our bodies. It's worth asking why. The Mayo Clinic study present facts, numbers and analysis that should inform the debate. Why are so many prominent Canadian health professionals ignoring it?
Andrea Mrozek is Manager of Research and Communications at the Institute of Marriage and Family Canada, www.imfcanada.org