Oral contraceptives & breast cancer / Committee on the Relationship Between Oral Contraceptives and Breast Cancer, Institute of Medicine, Division of Health Promotion and Disease Prevention.

Format:

Book

Author/Creator:

Institute of Medicine (U.S.). Committee on the Relationship Between Oral Contraceptives and Breast Cancer.

Language:

English

Subjects (All):

Breast--Cancer--Epidemiology--Congresses.

Breast.

Oral contraceptives--Side effects--Congresses.

Oral contraceptives.

Physical Description:

1 online resource (195 p.)

Edition:

1st ed.

Other Title:

Oral contraceptives and breast cancer

Oral contraceptives and breast cancer.

Place of Publication:

Washington, D.C. : National Academy Press, 1991.

Language Note:

English

Summary:

At least 10.7 million American women use oral contraceptives (OCs). The potential connection with breast cancer has caused concern among these OC users and uncertainty among many of their physicians. This new volume offers the most up-to-date information available on this critical topic. While the best available knowledge does not support any fundamental change in clinical practice with respect to the use of OCs, this book offers specific recommendations for more research to fully resolve the relationship between OCs and breast cancer. Noting consumer confusion, the volume includes a concise summary of benefits, risks, and other practical information for contraceptive users and their doctors. The volume presents current data on changes in patterns of OC use, differences in risk at different ages, the benefits of OCs, and more. Oral Contraceptives and Breast Cancer will be important reading for obstetricians/gynecologists and other health professionals, their patients who use OCs, contraceptive manufacturers, women's health advocates, policymakers, and researchers.

Contents:

Oral Contraceptives &amp

Breast Cancer

Copyright

Preface

Contents

Executive Summary

MAINTAINING SURVEILLANCE

DEVELOPING A BROADER ARRAY OF CONTRACEPTIVES

ASSESSING KNOWLEDGE FOR APPLICATION IN CLINICAL PRACTICE

FILLING GAPS IN BIOLOGICAL AND EPIDEMIOLOGICAL KNOWLEDGE

1 Introduction and Overview

BIOLOGICAL PLAUSIBILITY OF A LINK BETWEEN ORAL CONTRACEPTIVES AND BREAST CANCER

WHAT IS-AND IS NOT-KNOWN

SEEKING ANSWERS

2 Epidemiology: Information Needs and Data Gaps

EPIDEMIOLOGICAL RESEARCH

Case-Control Method

Cohort Studies

Comparison Groups

Ecological Studies

Special Studies

Women Exposed to Hormones Other than Oral Contraceptives

Women Genetically Susceptible to Breast Cancer

Estrogen Metabolism

Progestins

Changing Oral Contraceptive Formulations

SUMMARY AND CONCLUSIONS

3 Biology: Information Needs and Data Gaps

SIGNAL COMPLEXITY IN BREAST REGULATION

RESEARCH ISSUES

Relationships Among Cell Types

Receptors

Timing

Effects of Pregnancy and Lactation

Pathological Breast Tissue

Oncogenes

Molecular Changes Associated with Human Breast Cancer

Activated ras Mutations

Overexpression of Tyrosine Kinases

Amplification of int-2 and myc

Deletions of Genes

RESEARCH MODELS

Breast Cancer Cell Lines

Short-term Culture of Normal Mammary Epithelium

Organ Culture

Nude Mouse Model

4 Information for Users of the Pill and Health Care Providers

BENEFITS AND RISKS OF ORAL CONTRACEPTIVES

Benefits

Risks

CURRENT CONTROVERSY

PRESCRIBING PROBLEMS

5 Policy Issues and Recommendations

Cooperative Research

Surveillance Requirements of the Food and Drug Administration

DEVELOPING A BROADER ARRAY OF CONTRACEPTIVES.

ASSESSING KNOWLEDGE FOR APPLICATION IN CLINICAL PRACTICE

References

Appendixes

A Oral Contraceptives and Breast Cancer: A Review of the Epidemiological Evidence with an Emphasis ...

Changing Profile Of Oral Contraceptive Use

Biological Plausibility

Epidemiological Studies Of Breast Cancer and Oral Contraceptives

Ever" Use of Oral Contraceptives

Duration of Oral Contraceptive Use

Oral Contraceptive Use Before First Full-term Pregnancy or Before Age 25

Duration Since First Use of Oral Contraceptives (Latency)

Use of Oral Contraceptives in High-Risk Subgroups

Steroidal Potency of Various Formulations

Issues to Consider in Reviewing the Epidemiological Evidence

Discussion

The Future

B Oral Contraceptives and Breast Cancer: Review of the Epidemiological Literature

Methods

Results

Risk of Oral Contraceptive Users of All Ages in Developed Countries

Risk in Oral Contraceptive Users in Developing Countries

Risk in Oral Contraceptive Users With and Without Various Risk Factors for Breast Cancer

Risk in Relation to Early Use of Oral Contraceptives

Screening Bias

Risk in Relation to Use of Oral Contraceptives Near the Age of Menopause

Individual Formulations and Constituents of Oral Contraceptives

Conclusions, Interpretations, and Recommendations for Further Research

Acknowledgments

C The Evolving Formulations of Oral Contraceptives

Implications for Research

D Animal Models of Sex Steroid Hormones and Mammary Cancer: Lessons for Understanding Studies in Humans

Direct Tests of Carcinogenicity

Mice and Rats

Beagle Dogs

Pharmacokinetics of Various Steroids in Mice, Rats, and Beagles.

Studies of Mechanisms for Mammary Carcinogenicity of Sex Steroid Hormones in Mice, Rats, and Dogs

Conclusions

Interesting Questions Raised by Animal Studies

E Risks and Benefits of Oral Contraceptives: Will Breast Cancer Tip the Balance?

Established Benefits and Risks

Balance of Benefits and Risks

Oral Contraceptives and Breast Cancer

An Effect in Young Women

F List of Background Documents

Index.

Notes:

Bibliographic Level Mode of Issuance: Monograph

Includes bibliographical references and index.

ISBN:

9786610203604

9781280203602

1280203609

9780309597630

0309597633

9780585149011

0585149011

OCLC:

43477116