December 8, 2011
A controversial article in Lancet suggests nuns should be prescribed the contraceptive pill to help reduce their high rates of cancer.
By Matthew Thompson, Editor
The Catholic church should freely distribute the contraceptive pill to its almost 95,000 nuns in order to reduce their greatly increased risk of developing female-specific cancers, a paper published today in the Lancet says.
A comment-piece, The Plight of nuns: hazards of nulliparity, cites research directly linking the number of menstrual cycles a woman goes through to her risk of cancer, with younger arrival of periods or late onset of menopause being associated with higher cancer risk. Nuns, being childless, generally have no break from periods through their lives. The paper cites a study of US nuns showing that they suffer almost triple the rate of deaths from breast and uterine cancer as other women, and more than double the rate from uterine cancer.
Contraceptive pills have been shown to significantly reduce the incidence of ovarian and uterine cancer rates, the authors state, while forms of the pill are now available that suppress menstruation for months at a time or even altogether.
Professor John Hopper, a NHMRC Australia Fellow at the University of Melbourne, said that, if the papers recommendations were followed, it could put the church in an awkward position. Itd be wonderfully ironic for the Catholics to say its OK to use the pill if youre a nun, but not if youre not.
The paper quotes Italian Bernadino Ramazzini physician noting in 1713 that nuns suffered from extremely high rates of breast cancer.
A nun from the Sisters of Mercy said that it was known amongst nuns that if cancer were to strike them, it was likely to be breast cancer. The sister, who wished to remain anonymous, also said that the church did not bar nuns from taking the pill or other appropriate medicines if they were required for health.
Professor Hopper said that while the early formulations of the pill were dangerous for women, the new lower dose versions had been finessed until they now appeared to be beneficial. Well need to look at it over 20 years to be sure, but it certainly looks like it lowers the absolute risk of some cancers, he said. Professor Hopper said advocating the pill might easier said than done for nuns in poor countries where money was extremely tight.
The decision was complex even in developed countries whether or not a woman is a nun, said Dr Louise Keogh, a Health Sociologist & Senior Lecturer, at Melbourne Universitys Centre for Womens Health, Gender and Society. The decision to take the pill as a means of contraception is not a straight forward one for women in Australia. Women weigh up a range of risks and considerations how their body feels when they take the pill, what it indicates about their relationship, and whether it is what their friends are doing. In addition, a significant group of women (16%) cant take the pill for medical reasons, Dr Keogh said.
This decision would be even more complicated for nuns, who will not benefit from the contraceptive effect of the pill, and for whom there will undoubtedly be social, cultural and emotional factors to be considered. Further research is required to explore these wider implications, form the point of view of nuns, before we can be confident of the overall benefit of this proposal, Dr Keogh said.
The plight of nuns: hazards of nulliparity was co-written by Kara Britt, a Research Fellow at the works in Monash Universitys Faculty of Medicine, Nursing and Health Sciences, and Professor Roger Short, the Wexler Professorial Fellow at the University of Melbournes Department of Obstetrics & Gynaecology.
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