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Latent Effect of Oral Contraceptives on Breast Cancer-Reply FREE

James J. Schlesselman, PhD; Bruce V. Stadel, MD, MPH
JAMA. 1988;260(9):1241-1241. doi:10.1001/jama.1988.03410090068022
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In Reply.—  Dr McPherson's own data1 on OCs and breast cancer stand against his speculations on long-term latent effects. He finds an elevated risk of breast cancer with use, before first term pregnancy, of OCs containing ethinylestradiol but not for OCs containing mestranol, which is metabolized to ethinylestradiol. He reports a significant dose response and substantial elevation in risk (more than twofold for more than one year of OC use) at zero years' latency. Although the effect is maximal at ten years' latency, the elevated risk declines substantially—almost to levels at zero years' latency—at 12 and 14 years. This suggests that a short-term promotional effect on occult tumors is more compatible with his data than the specter of long-term latency, on the order of 20 years or more, which he raises in his letter.

REFERENCES

McPherson K, Vessey MP, Neil A, et al:  Early oral contraceptive use and breast cancer: Results of another case-control study . Br J Cancer 1987;;56:653-660.

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McPherson K, Vessey MP, Neil A, et al:  Early oral contraceptive use and breast cancer: Results of another case-control study . Br J Cancer 1987;;56:653-660.
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