For several days, the same title has been playing over and over: “the pill is as carcinogenic as tobacco or alcohol”. Information that sends chills down your spine, relayed with concern, even indignation. And yet, the reality is much more complex than this anxiety-provoking shortcut.
Yes, the WHO has indeed classified combined oral contraceptives in the group 1 carcinogens. This is the highest level, the one which includes products such as asbestos, UV rays… or cigarettes. But this classification does not mean that the pill is as dangerous as these substances. It means that the link between the pill and certain types of cancer is scientifically proven, which is very different.
What “Group 1 Carcinogen” Really Means
The International Agency for Research on Cancer (IARC), an agency dependent on the WHO, uses a grid in 5 groups to classify substances according to the level of evidence of their link with cancer in humans. Group 1 indicates that this link is established with certainty, based on solid studies. This is not a classification of the level of risk, nor a hierarchy of dangerousness.
The pill is therefore classified in group 1 not because it is extremely dangerous, but because the scientific data is numerous and consistent enough to establish a link between its intake and certain cancers, such as
that of the breast or cervix.
Please note: the risk increases slightly during the period of taking it, then drops again after stopping. For example, a study cited in the report suggests a
20 to 30% increased risk of breast cancer in women using combined estrogen-progestin pills, but this risk returns to normal 10 years after stopping.
Why the parallel with tobacco or alcohol is misleading
This is where things get confusing. The public hears “group 1” and thinks “extremely dangerous,” because they associate this category with massively deadly substances like tobacco or alcohol. This is not false, but it is off topic. Group 1 is a matter of scientific proof, no
quantity of cancers caused nor severity of danger on a daily basis.
Tobacco kills around 75,000 people each year in France,alcohol more than 40,000. The pill is a medication prescribed, monitored, supervised, and of which the benefits in terms of contraception and reproductive health are major.
Even more surprising:
the pill protects against other cancers. It notably reduces the risks of endometrial and ovarian cancers. The WHO report reiterates this in black and white, but this nuance has been largely absent from the headlines.
As gynecologist Geneviève Plu-Bureau, specialist in reproductive endocrinology, points out: “The benefit-risk ratio remains generally favorable for the majority of users, especially the youngest. The IARC classification does not call this into question.”
A decision that aims to inform, not alarm
This ranking is not a health alert. It does not question the legitimacy of the pill, nor does it push to remove it from the market. It is primarily used to
better inform health professionals and patients, so that they can integrate this data into the choice of contraceptive.
In practice this could mean:
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a better explanation of risks when prescribing,
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A more personalized choice according to age, medical history and lifestyle,
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and clearer information in the instructions, without being alarmist.
What this announcement also reveals is the need tobroaden the contraceptive range. Even today, the contraceptive burden rests almost exclusively on women, despite the existence of male avenues that are too little explored.
The real message from the IARC is therefore less of a warning than a call for transparency: the risks exist, they are measured, documented, but they do not make the pill “dangerous” in the sense that the general public often understands. Understanding this nuance means being able to choose consciously.
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