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CONTRACEPTIVE TECHNOLOGY UPDATE. 1992 Jan; 13(1):15-6.A recent World Health Organization (WHO) study found that women using Depo-Provera have only a slight increased risk of breast cancer. WHO examined case-control data from 5 hospitals in Africa, Mexico, and Thailand. The study revealed a 1.21 relative risk of breast cancer among all women in the study who had used Depo-Provera (a relative risk of 1.0 means that there is neither an increased or decreased likelihood to develop the disease in question). A relative risk of 1.21 indicates that there is a 21% increased likelihood of developing the disease, but any relative risk of less than 2.0 is considered slight. The study also found that among the diagnosed breast cancer cases, 12.5% had ever used Depo-Provera, compared to 12.2% among the control patients. Although an increased risk of breast cancer among women--especially women under 35--within the first 4 years of exposure to Depo-Provera was found, the risk did not increase with the duration of use, and it did not increase among women who had used the drug for more than 5 years. WHO explains that the risk of breast cancer among Depo-Provera user is similar to that found among oral contraceptives users, whose relative risk ranges from 1.0-1.42. Based on their findings, WHO investigators estimate that there would be 7-8 new cases of breast cancer per 100,000 Depo-Provera users annually, compared to 5 new cases annually among women who had not used the drug. As a recent commentary by Family Health International (FHI) points out, this increased risk of breast cancer must be weighted against the benefits provided by Depo-Provera. FHI concludes that there is a net gain for women using Depo-Provera, since despite the slight risk of breast cancer, it would result in a higher life expectancy compared to women not using contraception.