What are patients seeing on social media about cancer and birth control?
Social media is full of alarming posts that claim hormonal birth control causes cancer, highlighting vague cancer risks as well as more specific cancer risks, like breast cancer.
What’s the evidence around birth control and cancer risk?
- A persistent myth is that hormonal contraception significantly increases cancer risk.
- The current evidence paints a nuanced—and broadly reassuring—picture.
- While there may be a slight increase in the relative risk of breast cancer among users of hormonal birth control, the absolute risk is very low. ACOG recommends discussing the data in a clear, supportive way.
- Combined oral contraceptives (COCs) are associated with long-term protective effects against several other cancers, including ovarian and endometrial cancers.
Citations
- American College of Obstetricians and Gynecologists. Hormonal Contraception and Risk of Breast Cancer. Practice Advisory. January 2018; reaffirmed October 2024.
- Iversen L, Fielding S, Lidegaard Ø, Hannaford PC. Contemporary hormonal contraception and risk of endometrial cancer in women younger than age 50: A retrospective cohort study of Danish women. Contraception. 2020;102(3):152-158. doi:10.1016/j.contraception.2020.06.008
- Iversen L, Sivasubramaniam S, Lee AJ, Fielding S, Hannaford PC. Lifetime cancer risk and combined oral contraceptives: the Royal College of General Practitioners’ Oral Contraception Study. Am J Obstet Gynecol. 2017;216(6):580.e1-580.e9. doi:10.1016/j.ajog.2017.02.002
- Minalt N, Caldwell A, Yedlicka GM, et al. Association between intrauterine device use and endometrial, cervical, and ovarian cancer: an expert review. Am J Obstet Gynecol. 2023;229(2):93-100. doi:10.1016/j.ajog.2023.03.039
- Mørch LS, Skovlund CW, Hannaford PC, Iversen L, Fielding S, Lidegaard Ø. Contemporary Hormonal Contraception and the Risk of Breast Cancer. N Engl J Med. 2017;377(23):2228-2239. doi:10.1056/NEJMoa1700732
Talking with patients about cancer concerns
Get curious:
Start by learning more about where their concerns are coming from:
Can you tell me more about your concerns about cancer?
This gives patients space to share personal experience, family histories, or social media information that shape their concern. Sometimes people have a close family member or friend who has had a certain type of cancer. Or they may have read an article about how more young people are getting diagnosed with certain types of cancers. The more information you gather, the better you can respond to their specific concern(s).
Acknowledge concerns & normalize:
Don’t jump to citations—start with empathy.
I totally get why you’d be worried about that.
I can see you’ve really thought a lot about your health. I’m glad we’re talking about this.
Clarify with evidence and empathy:
Concern about family history:
If you’re interested, we can talk about genetic counseling or testing that could possibly provide you with helpful information. And from what we know at this point, even for people with a family history, both hormonal and nonhormonal birth control are safe options.
Vague concern about hormones and cancer:
Try a both/and approach here—it can work well.
Lots of research tells us that there is not a strong connection between cancer and birth control. And some birth control actually reduces the risk of certain types of cancers. That said, some people still feel more comfortable with non-hormonal methods. Would you like to talk about those options today?
Worry about a specific type of cancer (i.e., ovarian or breast):
Thats a good question. Would it be helpful if we looked at a study together about that?
Diving deeper
Educate patients on other, more significant modifiable factors for cancer risk, such as sun exposure, smoking, alcohol, and lack of immunization against HPV.
Key takeaways
- Hormonal contraception does not broadly increase cancer risk.
- There may be a small increase in breast cancer risk, but the absolute risk is very low.
- COCs provide long-term protective effects against ovarian, endometrial, and other cancers.
- Use a balanced, supportive tone when discussing risks. Pair reassurance about hormonal contraception’s overall safety with options for non-hormonal methods if desired.
- When appropriate, offer referrals for genetic counseling and explore research with your patient.
- Support reproductive well-being by providing relevant education on modifiable factors that can impact cancer risk such as sun exposure, smoking, alcohol, and HPV exposure without immunization.