The MacDoctor sees that the Lancet is up to its old tricks again – publishing controversial comments and papers with poor scientific reasoning behind them. You would have thought that almost single-handedly producing the anti-vaccine movement with a poorly researched, bogus article would have taught them some caution, but apparently not.
Not yet published in print, but available online, there is this commentary: Britt K, Short R. The plight of nuns: hazards of nulliparity Lancet online DOI:10.1016/S0140- 6736(11)61746-7. It is subscription only but here is the main premise:
“The Catholic Church condemns all forms of contraception except abstinence, as outlined by Pope Paul VI in Humanae Vitae in 1968.13 Although Humanae Vitae never mentions nuns, they should be free to use the contraceptive pill to protect against the hazards of nulliparity since the document states that “the Church in no way regards as unlawful therapeutic means considered necessary to cure organic diseases, even though they also have a contraceptive effect”. If the Catholic Church could make the oral contraceptive pill freely available to all its nuns, it would reduce the risk of those accursed pests, cancer of the ovary and uterus, and give nuns’ plight the recognition it deserves.”
The argument in a nutshell is based on the well-attested fact that nulliparity (not having any children) increases your overall risk of breast, uterine and ovarian cancer. The combined oral contraceptive pill has some protective effect against the latter two. Therefore nuns should be allowed to take the pill to protect them from cancer.
This argument falls in a number of areas. Firstly, in the graph that the authors publish to “prove” their point (shown below), it can be seen that nuns are only at risk from increased rates of uterine and ovarian cancer in their 80s. As these two cancers are rare diseases anyway, it would seem that their relative risk of dying from these diseases is still likely to be very small. There is an appreciable risk from the far more common breast cancer, but the oral contraceptive has not been shown to protect against breast cancer and may, in fact, increase the risk slightly.
Secondly, these graphs make no effort to determine the other risks of the pill relative to nuns, notably thromboembolism (clots in the legs and the lungs) and high blood pressure. We know that the pill reduces mortality for women overall, but that is because taking the pill is much safer than having babies. This factor is not a consideration for nuns. It may well be (in fact I would consider it likely) that the risks of the oral contraceptive will outweigh any gains. Particularly as the authors are essentially proposing that nuns take the pill continually, unlike most women. We have no idea whether this imposes additional risks to the taker.
Finally, the fact is that nuns live, on average, 5 years longer than women in general (I do not recollect the name of the paper I saw this in, but the study involved 70+ thousand nuns and seems quite robust). This is probably due to a number of factors such as reduced stress, reduced likelihood of accident and healthier lifestyles. Their choice to dedicate their lives wholly to God does them no harm and provides them with long, often very healthy lives. It is absurd to take a single aspect of an otherwise healthy lifestyle and blow in out of all proportion. Indeed, it seems that the only purpose of the authors is to castigate the Pope for his decree against contraception because there appears to be no valid medical or clinical purpose evident. This kind of nonsense is best left to the tabloids and does not belong in a reputable medical journal.