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How a study on hormonal contraception and breast cancer was distorted

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How a study on hormonal contraception and breast cancer was distorted

As misinformation about women’s health spreads faster than ever, doctors say new research on the risks of hormonal birth control underscores the challenge of communicating nuance in the social media age.

The study, which was conducted in Sweden and tracked more than 2 million teenage girls and women less than age 50 for more than a decade, found that hormonal contraception remains safe overall, but also found small differences in breast cancer risk based on the hormones used in the formulation.

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In addition, the researchers observed a small, short-term rise in breast cancer diagnoses among current or recent users. Those findings are consistent with prior large studies, including a 2017 Danish registry analysis and a 2023 meta-analysis.

It was published online on October 30 in JAMA Oncology.

Doctors say these study results won’t change how they advise patients and that women should not stop using their birth control.

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Still, TikTok is flooded with factually incomplete warnings that contraceptives cause cancer and are as dangerous as smoking. Reproductive health advocates warn that studies like this can easily be taken out of context online and be reduced to a single alarming number.

Case in point: The study reported that women who had used hormonal birth control had about a 24 percent higher rate of breast cancer than women who hadn’t. But because breast cancer is still uncommon in younger women, that works out to an increase from roughly 54 to 67 breast cancer cases per 100,000 women per year – about 13 extra cases per 100,000 women, or about one extra case per 7,800 users of hormonal contraceptives per year.

Co-authors Asa Johansson and Fatemeh Hadizadeh, epidemiologists at Uppsala University, said the rise is modest and short-term, with risk highest during current use and fading within five to 10 years after stopping.

Rachel Fey, interim co-CEO of Power to Decide – a group whose mission is to provide accurate information on sexual health and contraceptive methods – said that kind of nuance is exactly what tends to disappear on social media.

“I get really angry at this because it’s designed to scare people like me away from birth control, which has made my life so much better in so many ways,” she said. “It’s really frustrating … especially when it’s given without context. And then in this era of social media, it can just take off without anybody who knows what they’re talking about providing that context.”

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The researchers also found the risk was slightly higher with certain progestins such as desogestrel – found in combined oral contraceptives like Cyred EQ, Reclipsen, Azurette, and Pimtrea – but did not increase with others, such as medroxyprogesterone acetate injections, sold under the brand name Depo‑Provera.

How to interpret the findings

Some experts say the results should be viewed with care because the study counted both invasive breast cancers and early, noninvasive lesions known as in situ tumours, growths that may never become life-threatening. Including these precancerous cases could make the overall risk of clinically significant disease appear higher than it is.

“A substantial proportion of the ‘cases’ would never have progressed to invasive breast cancer,” said Lina S Morch, a senior researcher and team leader at the Danish Cancer Institute. Morch was not associated with the Swedish study. She added that experts should wait for more data separating early-stage and advanced cancers before making new rules or warnings about specific hormones.

The doctor-patient conversation

Even as scientists debate how to interpret the finer points of the data, physicians emphasise that for most patients, the study reinforces what they already discuss in the exam room: That hormonal birth control is broadly safe, and decisions should be tailored to each woman’s needs and values.

Katharine White, chief of Obstetrics and Gynaecology at Boston Medical Center, said this study won’t change how she talks to her patients.

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“When counselling patients about their contraceptive options, I focus on their past experiences with birth control, their medical history, and what’s important to them about their birth control method and pregnancy planning (if applicable),” White wrote in an email. “Side effects and risks of methods are already a key part of my counselling about both hormonal and non-hormonal methods.”

Other doctors noted there are other contraceptive options.

Eleanor Bimla Schwarz, chief of General Internal Medicine at Zuckerberg San Francisco General Hospital, said, “For those who prefer hormone-free contraception, the copper IUD offers safe, convenient, highly effective contraception for over a decade after placement, and is rapidly reversible when pregnancy is desired,” referring to a type of long-acting intrauterine device.

Mary Rosser, director of Integrated Women’s Health at Columbia University Irving Medical Center, said this was a large, high-quality study that looked at many types of hormones over many years. But she added that doctors shouldn’t change their advice yet.

Johansson and Hadizadeh stressed that the results should guide shared decision-making, not cause alarm. “It may be reasonable to consider formulations associated with lower observed risk in our data,” they said. They noted that products containing medroxyprogesterone acetate, drospirenone, or levonorgestrel were linked to lower risk, while long-term use of desogestrel-only contraceptives might be best avoided when other options fit.

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Keeping the risk in perspective

Hormonal birth control provides many health benefits beyond pregnancy prevention. It can lighten heavy periods, ease pain from endometriosis, and lower the risk of ovarian and uterine cancers for years after stopping. Morch noted that even small risks are worth discussing, but said decisions should be guided by women’s “values and preferences”.

White said it’s important to see the big picture. “The risk of an unintended pregnancy is 85 percent for people who do not use contraception – so any risks of birth control need to be weighed against the risk of an unexpected pregnancy,” she wrote.

KFF Health News is a national newsroom that partners with PolitiFact and produces in-depth journalism about health issues.

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Live updates: Tracking Venezuela oil tankers as US seizes Russian-flagged vessel

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Live updates: Tracking Venezuela oil tankers as US seizes Russian-flagged vessel

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Kylie is the Global Live Pages Editor, leading a team providing real-time multimedia coverage of the biggest breaking stories worldwide. She previously worked on the UK Breaking News team, and spent eight years in Westminster as a UK political correspondent – a period which included the Scottish independence referendum, Brexit and several general elections. She originally joined Reuters as a graduate trainee and has also covered investment banking.

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Farouq is a Live Page Journalist, covering Reuters international news stories. He previously worked as a correspondent on the UK Breaking News team, reporting on general news across the United Kingdom.

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Vanessa Balintec is a Live Page Journalist based in Toronto, Ontario. She helps create and curate multimedia posts for Reuters’ Live Pages — a scrolling feed of multimedia posts for some of the biggest stories of the day. She previously worked at various bureaus for CBC News. Contact: vanessa.balintec@thomsonreuters.com

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Iranian protesters rename Tehran street after Trump, plead ‘don’t let them kill us’ amid crackdown

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Iranian protesters rename Tehran street after Trump, plead ‘don’t let them kill us’ amid crackdown

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Iranian protesters intensified nationwide demonstrations over the past 24 hours, directly appealing to President Donald Trump while chanting anti-regime slogans. Footage published Wednesday showed a protester in Tehran symbolically renaming a street after Trump, while other videos captured handwritten appeals reading, “Don’t let them kill us,” Iran International reported.

Holly Dagres, a senior fellow at the Washington Institute, posted the video on X stating, “Since Trump’s comments about the Iran protests, I’ve seen numbers videos of Iranian protesters either thanking him or, in this case, renaming streets after the US president.”

The appeals came as demonstrators faced a widening security crackdown, including the deployment of armed units and tear gas near major civilian sites in Tehran.

TRUMP SIGNS ‘MAKE IRAN GREAT AGAIN’ HAT ALONGSIDE LINDSEY GRAHAM

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Exiled Iranian opposition leader Reza Pahlavi said the current unrest represents a historic opportunity to end Iran’s Islamic Republic.

“In all these years, I’ve never seen an opportunity as we see today in Iran,” Pahlavi said in an interview aired Tuesday on “Hannity.”

“Iranian people are more than ever committed to bringing an end to this regime, as the world has witnessed in the last few days, the level of demonstrations is unprecedented in Iran,” he said.

Pahlavi said protests have spread to more than 100 cities and emphasized the role of Iran’s traditional merchant class, describing developments inside the country’s bazaars as a turning point. “We are beginning to see more and more defections,” Pahlavi said, adding that “Either way, the regime is crumbling and is very close to collapsing.”

IRAN ON THE BRINK AS PROTESTERS MOVE TO TAKE TWO CITIES, APPEAL TO TRUMP

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Sen. Lindsey Graham, R-S.C., posted a photo of himself posing with President Donald Trump, who is holding a signed “Make Iran Great Again” hat. (Lindsey Graham / X)

Over the past 24 hours, Iran International reported continued protests and strikes across the country, including in Tehran, Tabriz, Qazvin, Kermanshah, Kerman, Shiraz, Falavarjan and Bandar Abbas. Tehran’s Grand Bazaar remained a focal point of unrest, with large crowds chanting against Iran’s leadership as authorities responded with tear gas and armed deployments.

Security operations expanded into sensitive civilian locations. Videos published by Iran International showed tear gas used near or inside Tehran’s Sina Hospital and the Plasco Shopping Center.

Protesters hold signs during a demonstration in Iran amid ongoing unrest, according to images released by the Iranian opposition group National Council of Resistance of Iran. (NCRI )

Casualty and arrest figures continued to rise. The Human Rights Activists News Agency, cited by Iran International on Wednesday, reported at least 36 people killed since protests began, including 34 protesters and two members of Iran’s security forces, with more than 2,000 arrests nationwide. Iranian authorities have not released updated official figures.

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New footage from the past day showed demonstrators lighting fires in the streets of Shiraz and chanting “Death to Khamenei,” referring to Supreme Leader Ali Khamenei. In Qazvin, protesters were heard chanting, “Law enforcement, return to the side of the nation.”

Iranian protesters try to take control of two cities in western Iran as nationwide unrest continues, with demonstrators chanting ‘Death to Khamenei’ in the streets. (Getty)

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Workers also joined the unrest, with strikes reported at the South Pars gas refinery and widespread shop closures at major markets in Tehran and Tabriz.

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How Ukraine is shaping Europe’s response to Trump’s Greenland threats

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How Ukraine is shaping Europe’s response to Trump’s Greenland threats

For the past year, staying in Donald Trump’s good graces has become a top priority for European leaders, who have gone the extra mile to appease the mercurial US president, rein in his most radical impulses and keep him firmly engaged in what is their be-all and end-all: Russia’s war on Ukraine.

Though Europe is by far the largest donor to Kyiv, nobody on the continent is under the illusion that the invasion can be resisted without US-made weapons and come to an eventual end without Washington at the negotiating table.

In practice, the strategic calculus has translated into painful sacrifices, most notably the punitive tariffs that Trump forced Europeans to endure.

“It’s not only about the trade. It’s about security. It is about Ukraine. It is about current geopolitical volatility,” Maroš Šefčovič, the European Commissioner for Trade, said in June as he defended the trade deal that imposed a sweeping 15% tariff on EU goods.

The same thinking is now being replicated in the saga over Greenland’s future.

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As the White House ramps up its threats to seize the vast semi-autonomous island, including, if necessary, by military force, Europeans are walking an impossibly thin line between their moral imperative to defend Denmark’s territorial integrity and their deep-rooted fear of risking Trump’s wrath.

The precarity of the situation was laid bare at this week’s meeting of the “Coalition of the Willing” in Paris, which French President Emmanuel Macron convened to advance the work on security guarantees for Ukraine.

The high-profile gathering was notable because of the first-ever in-person participation of Steve Witkoff and Jared Kushner, the chief negotiators appointed by Trump.

At the end of the meeting, Macron hailed the “operational convergence” achieved between Europe and the US regarding peace in Ukraine. By his side, British Prime Minister Keir Starmer was equally sanguine, speaking of “excellent progress”.

But it did not take long for the elephant in the room to make an appearance.

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Hard pivot

The first journalist who took the floor asked Macron whether Europe could “still trust” America in light of the threats against Greenland. In response, the French president quickly highlighted the US’s participation in the security guarantees.

“I have no reason to doubt the sincerity of that commitment,” Macron said. “As a signatory of the UN charter and a member of NATO, the United States is here as an ally of Europe, and it is, as such, that it has worked alongside us in recent weeks.”

Starmer was also put on the spot when a reporter asked him about the value of drafting security guarantees for a country at war “on the very day” that Washington was openly talking about seizing land from a political ally.

Like Macron, Starmer chose to look at the bright side of things.

“The relationship between the UK and the US is one of our closest relationships, particularly on issues of defence, security and intelligence,” the British premier said. “And we work with the US 24/7 on those issues.”

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Starmer briefly referred to a statement published earlier on Tuesday by the leaders of France, Germany, Italy, Poland, Spain, the UK and Denmark in defence of Greenland.

The statement obliquely reminded the US to uphold “the principles of sovereignty, territorial integrity and the inviolability of borders” enshrined in the UN Charter – precisely the same tenets that Moscow is violating at large in Ukraine.

The text did not contain any explicit condemnation of the goal to forcefully annex Greenland and did not spell out any potential European retaliation.

“Greenland belongs to its people. It is for Denmark and Greenland, and them only, to decide on matters concerning Denmark and Greenland,” its closing paragraph read.

Conspicuous silence

The lack of censure was reminiscent of the European response to the US operation that just a few days earlier removed Nicolás Maduro from power in Venezuela.

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Besides Spain, which broke ranks to denounce the intervention as a blatant breach of international law, Europeans were conspicuously silent on legal matters. Rather than condemn, they focused on Venezuela’s democratic transition.

Privately, officials and diplomats concede that picking up a fight with Trump over Maduro’s removal, a hostile dictator, would have been counterproductive and irresponsible in the midst of the work to advance security guarantees for Ukraine.

The walking-on-eggs approach, however, is doomed to fail when it comes to Greenland, a territory that belongs to a member of both the EU and NATO.

Danish Prime Minister Mette Frederiksen has warned that the entire security architecture forged at the end of World War II, which allies have repeatedly invoked to stand up to the Kremlin’s neo-imperialism, would collapse overnight in the event of an annexation. The worry is that trying to stay in Trump’s good graces at all costs might come at an unthinkable price.

“Europeans are clearly in a ‘double-bind’: Since they are in desperate need of US support in Ukraine, their responses to US actions – whether on Venezuela or Trump threatening Denmark to annex Greenland – are weak or even muted,” said Markus Ziener, a senior fellow at the German Marshall Fund.

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“Europeans are afraid that criticising Trump could provide a pretext for the US president to conclude a peace deal at Ukraine’s and Europe’s expense. Is this creating a credibility gap on the part of the EU? Of course. But confronted with a purely transactional US president, there seems to be no other way.”

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