Even Low-Dose Contraceptives Slightly Increase Breast Cancer Risk

Katherine Streeter for NPR

Katherine Streeter for NPR

It’s long been known that hormonal contraception, like any medicine, carries some risks. But doctors and women have hoped that the newer generations of low-dose contraceptive pills, IUDs and implants eliminated the breast cancer risk of earlier, higher-dose formulations.

Now a big study from Denmark suggests the elevated risk of getting breast cancer — while still very small for women in their teens, 20s and 30s – holds true for these low-dose methods, too.

In the research published Wednesday in the New England Journal of Medicine, a team of scientists studied 1.8 million women between the ages of 15 and 49. They were looking to see what happened over a stretch of nearly 11 years among women who used hormonal birth control — usually a combination of estrogen and progestin — versus women who relied on non-hormonal contraceptive methods, such as a condom, diaphragm or copper IUD.

Unlike most previous research, this study didn’t just track the effect of birth control pills. Because their set of data was very large, scientists this time were also able to get a good sense of the impact of various other hormonal methods — including the birth control patch, the ring, and implants as well as hormone-releasing IUDs.

The results showed it didn’t much matter what sort of hormonal method was used, says Lina Morch, a research epidemiologist at the University of Copenhagen, who led the study.

Overall, Morch says, she and her colleagues found “a roughly 20 percent increased risk [of breast cancer] among women who currently use some type of hormonal contraception.” And the longer the women used hormonal methods, she says, the higher their risk.

That may sound scary. But Morch and other doctors say it’s important to consider how that additional risk translates in terms of actual cases of breast cancer. The illness is fairly rare among women in the age group studied.

“A 20 percent increase of a very small number is still a very small number,” says Mia Gaudet, an epidemiologist with the American Cancer Society. The risk contributed by hormonal contraception, she says, is similar to the extra breast cancer risk contributed by physical inactivity, excessive weight gain in adulthood, or drinking an average of one or more alcoholic drinks per day.

“The absolute increase in risk [found in the study] is 13 per 100,000 women overall, but only 2 per 100,000 women younger than 35 years of age,” writes epidemiologist David Hunter, of the University of Oxford, in an editorial accompanying the study in NEJM.

“Most of the cases that occurred in this analysis occurred among women who were using oral contraceptives in their 40s,” Hunter adds.

Any additional risk of breast cancer, he says, should be weighed against the clear benefits of hormonal contraception — benefits that go beyond the obvious advantages of preventing unwanted pregnancy.

“There’s very good evidence,” Hunter says, “that oral contraceptives reduce the risk of ovarian cancer. They reduce the risk of endometrial cancer. And there’s a strong suggestion they also reduce the risk of colorectal cancer. So, many calculations suggest that the use of oral contraceptives actually prevents more cancers than it causes.”

The search for new hormonal contraceptives — methods that don’t elevate breast cancer risk at all — should continue, Hunter says.

Meanwhile, a conversation with your doctor can help you figure out which contraceptive method makes most sense for you.

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Why So Many Children Have Been Killed In Syria

A man evacuates a child from building destroyed by airstrikes in Douma, Syria, in January 2016.

Sameer Al-Doumy/AFP/Getty Images

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Sameer Al-Doumy/AFP/Getty Images

Researchers have strong evidence that bombs in Syria were targeting civilians, including women and children.

In the past seven years, barrel bombs have killed civilians almost exclusively, scientists in Belgium report Wednesday. Civilians comprised 97 percent of the deaths from these bombs.

“That is a very big deal,” says Debarati Guha-Sapir, an epidemiologist at the Universite Catholique de Louvain in Brussels, who led the study. “Killing 97 percent [of] civilians is not ‘collateral damage.’ Governments are either missing combatants on purpose, or they have very inept war strategies.”

The study also finds a dramatic rise in the number of children killed as the war has progressed.

Children represented a small proportion of deaths, about 9 percent, in the first two years of the war. But since 2013, that proportion has more than doubled. Now nearly 1 in 4 civilian deaths are children, Guha-Sapir and her team report in the journal Lancet Global Health.

“This increase is directly associated with the use of aerial bombings,” Guha-Sapir says. “We conclude that the use of bombs ends up targeting children and women more than targeting combatants.”

In the late 2000s, Guha-Sapir was instrumental in documenting war crimes and genocide in Darfur, Sudan and testified about her findings at the Hague.

“I’ve analyzed data from Iraq, Darfur, the Congo — places with very problematic wars,” she says. “Deaths of children were usually associated with lack of access to medical care, vaccination, postnatal care because of the war. By and large, children did not die directly because of war weapons.”

That’s not the case in Syria.

So far, at least 14,000 children have been killed in Syria by snipers, machine guns, missiles, grenades, roadside bombs and aerial bombs. About a thousand children have been executed. And more than a hundred were tortured and then executed.

But barrel bombs have been especially deadly for children and women. Children have comprised nearly a third of all deaths from barrel bombing.

“That percentage is really unacceptable,” says Dr. Hani Mowafi, at Yale University, who wasn’t involved in the study. “These are weapons that can be used really only on people who can’t fight back.”

A barrel bomb is essentially a large metal container filled with explosives and shrapnel. They can be incredibly powerful, decimating entire city blocks. But they are very imprecise weapons.

“Many times the barrel bombs are simply dropped from low-flying helicopters onto densely populated parts of cities,” Mowafi says. “You couldn’t drop them onto combatants because they would simply shoot down the helicopter.”

Instead, barrel bombs are used to terrorize families and convince them to leave a city, Mowafi says. “We’ve seen barrel bombing of hospitals, which are clearly marked. We’ve seen barrel bombing of people queuing up to get bread.”

The new study raises “serious questions” about the war-fighting methods in Syria, Mowafi says. In particular, whether or not governments are really trying to differentiate between civilians and combatants with aerial bombs.

“The findings in this study are really important because the authors have adhered to international standards for reporting on war deaths,” Mowafi says. “It is very difficult to do this type of study well, and the authors have done a really good job.”

In the study, Guha-Sapir and her colleagues analyzed data documenting the deaths of nearly 150,000 people in Syria from 2011 to 2016. About 70 percent of those deaths were civilians.

The data come from a group of activists inside Syria, called Violations Documentation Center, dedicated to documenting deaths caused by war weapons.

The group has a network of volunteers which rush to a site of an attack and begin collecting information about who died. They document the person’s age, gender, military status and how they died. The group reports its data directly to the U.N. Security Council.

“They have a very robust data set,” Mowafi says. “The group often collects information within hours of a death, and then they corroborate the information with independent reports.”

The data are not comprehensive, he notes. VDC documents deaths only in regions not controlled by the government because the group has access only in those regions.

“And the VDC only includes deaths when they can corroborate the information,” Mowafi says. “Clearly more people have died than are reported here, but the study represents one of the most complete accounts of war deaths in the Syria to date.”

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Kim Davis Once Denied Him A Marriage License, Now Kentucky Man Seeks Her Job

David Ermold (right) files to run for Rowan County Clerk as Kim Davis looks on, two years after Davis denied Ermold and his now-husband a marriage license because she was opposed to gay marriage.

Adam Beam/AP

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Adam Beam/AP

David Ermold once again stepped inside the Rowan County courthouse in Kentucky on Wednesday, except this time he wasn’t asking for a marriage license, he was asking for Kim Davis’ job. She is the Rowan County clerk who refused Ermold and his partner, among other couples, a marriage license on the basis of her religious beliefs against gay marriage.

“I have an obligation here, really, to do this and to set things right,” Ermold told the Associated Press about his decision to run for the position. “I don’t think the other candidates are looking at a larger message.”

Ermold is an assistant professor of English at the University of Pikeville and has lived in Morehead, Rowan County, Ky., for more than a decade. He received a clear message from Davis when she twice denied him and his now-husband marriage licenses in the summer of 2015, after the Supreme Court effectively legalized same-sex marriage.


Davis told Ermold that it was “God’s authority” that kept her from complying with the Supreme Court. She spent time in jail for defying a federal judge’s order, was sued by Ermold and Moore and other couples, and rose to international prominence as a symbol of the bitter divide over same-sex marriage, even meeting with the Pope in 2015.

Last month Davis announced that she would be running for reelection, seeking the judgment of voters for the first time since the controversy erupted.

The AP described the scene on Wednesday as Ermold, alongside his now-husband, filled out the paperwork to run for office with Davis sitting across from him:

“Davis smiled and welcomed them, chatting with them about the state retirement system and the upcoming Christmas holiday. She made sure Ermold had all of his paperwork and signatures to file for office, softly humming the old hymn ‘Jesus Paid It All’ as her fingers clacked across a keyboard.

“When it was over, she stood and shook hands with Ermold, telling him: ‘May the best candidate win.'”

Ermold and Moore finally married in the fall of 2015.

Ermold told Newsweek that he wants to send a message to people who have been discriminated against. “We need to not just symbolize. We need to send a message out to all these people saying it’s OK,” Ermold said. “You are important.”

Ermold, who is running as a Democrat, told the AP that his campaign will be about more than LGBT issues and will focus on fairness and bringing people together.

He added, “It doesn’t matter whether I’m LGBT or not. If I’m qualified to do a job, I should be able to do the job.”

Social issues aside, that job is in many ways simply about keeping records. As Ermold’s campaign web site pledges, “As county clerk, I will act responsibility with taxpayer money, and I will seek out ways to be cost efficient … and I will keep accurate records of all transactions.”

Davis no longer objects to issuing marriage licenses to same-sex couples now that Kentucky changed the rules so that clerks no longer have to attach their names to the licences.

But she has maintained her opposition to gay marriage, even visiting Romania in October to urge that country to change its constitution to bar same-sex marriage.

When asked on Wednesday if she thinks she deserves to be reelected, Davis, who is running as a Republican, told reporters, “That will be up to the people. I think I do a good job.”

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Senior Volkswagen Executive Sentenced In Diesel-Emissions Scandal

Volkswagen executive Oliver Schmidt was sentenced to 7 years in prison for conspiring to evade U.S. clean air laws.


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High-ranking U.S.-based Volkswagen executive, Oliver Schmidt, has been sentenced to seven years in prison and ordered to pay a $400,000 fine for his part in a decadelong diesel-emissions cheating scandal.

Schmidt was the chief of Volkswagen’s engineering and environmental office in Michigan. In August, he pleaded guilty to charges of conspiracy to defraud the federal government and violation of the Clean Air Act by participating in a scheme to circumvent federal emissions tests with rigged devices in diesel cars. Federal regulators uncovered the plot in 2015.

Volkswagen already has admitted guilt to charges of conspiracy to commit wire fraud, customs violations, obstruction of justice, as well as violation of the Clean Air Act. The German company has paid more than $20 billion in fines and settlements.

In a letter to U.S. District Judge Sean Cox of Detroit, Schmidt acknowledged his guilt. Reading a written statement in court, Schmidt broke down saying, “I made bad decisions and for that I am sorry.”

Federal prosecutors also have charged eight other current or former Volkswagen executives. As The New York Times reports:

“But most of the people suspected of taking part in a conspiracy to defraud United States regulators are out of reach of American justice in Germany, which normally does not extradite its own citizens. Mr. Schmidt may well turn out to suffer the harshest punishment for the emissions fraud even though he was not by any means the only participant or the highest ranking.”

Schmidt was arrested in January while vacationing in Miami with his wife.

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Airlines Restrict 'Smart Luggage' Over Fire Hazards Posed By Batteries

Three major U.S. airlines have announced new restrictions on “smart luggage” due to the fire hazard posed by lithium-ion batteries in cargo holds. The airlines say any such batteries need to be removable.

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Airlines including American, Delta and Alaska have announced restrictions on so-called smart luggage because the lithium-ion batteries found in many of these suitcases pose a fire risk.

These kinds of bags have proliferated in recent years, including motorized suitcases you can ride and one pitched as an autonomous “robot companion” that follows you around.

Prices can range from $275 to more than $1,000, depending on a bag’s bells and whistles, things like device charging, GPS tracking, remote locking and built-in weight sensors. But these features require power, often in the form of lithium-ion batteries.

The batteries are in many electronics these days, because they are extremely efficient. But lithium batteries have the potential to overheat and ignite, as shown in dramatic fashion by the Samsung Galaxy Note 7, which the Department of Transportation banned from flights last fall after dozens of reports of the smartphone’s batteries smoking, catching fire and exploding. In 2015, many airlines banned hoverboards due to similar concerns.

“Beginning Jan. 15, customers who travel with a smart bag must be able to remove the battery in case the bag has to be checked at any point in the customer’s journey. If the battery cannot be removed, the bag will not be allowed,” American said in a statement on Friday. The same day, Delta and Alaska announced similar policies on their flights.

American’s policy dictates that if the bag is carry-on size, passengers can take the luggage on board, so long as the battery can be removed if needed. If passengers need to check the bag, the battery must be removed and carried onboard. But if the bag has a non-removable battery, it can’t be checked or carried on.

An FAA spokesman toldThe Washington Post that the airlines’ policies are “consistent with our guidance that lithium-ion batteries should not be carried in the cargo hold.”

The FAA’s policy on portable electronic devices containing these batteries states:

“Devices containing lithium metal or lithium ion batteries (laptops, smartphones, tablets, etc.) should be carried in carry-on baggage when possible. When these devices must be carried in checked baggage, they should be turned completely off, protected from accidental activation, and packed so they are protected from damage.

“Spare (uninstalled) lithium metal and lithium ion batteries are always prohibited in checked baggage and must be placed in carry-on. When a carry-on bag is checked at the gate or at planeside, any spare lithium batteries must be removed from the bag and kept with the passenger in the aircraft cabin.”

In May, the International Air Transport Association, an airline trade association, published suggested smart bag guidelines for airlines. Its list of hazards and potential consequences is enough to make any flyer a little nervous.

A spokesman for American tells NPR that rules banning the bags’ powerful lithium batteries from checked baggage aren’t because they’re more likely to catch fire in a cargo hold, but because it’s hard to fight a fire that breaks out there.

“You have very limited options in the cargo hold,” American spokesman Ross Feinstein says. If a fire starts there, the crew can use fire suppression bottles to fight it, “but you can only deploy them once.”

“In the cabin, passengers and crew can fight a fire,” he adds.

For manufacturers of luggage with non-removable batteries, the airlines’ restrictions are a blow.

“Before and at the time of production, we did our due diligence to make sure that we complied with all international regulations defined by DOT and FAA,” one such company, Bluesmart, said on its website. “While most airlines understand and approve of smart luggage, others might still be getting up to speed. We are saddened by these latest changes to some airline regulations and feel it is a step back not only for travel technology but it also presents an obstacle to streamlining and improving the way we all travel.”

Some luggage makers advertise that their bags are “TSA-approved.”

But TSA does not approve or endorse bags. And Feinstein says that on American, there won’t be any exemptions to its policies, no matter the manufacturer.

“We know these bags are getting popular,” Feinstein says. “American is not opposed to smart bags. However, the battery must be removable.”

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50+ Mayors Sign Pact To Reduce Greenhouse Gas Emissions

North American Climate Summit

Chicago Mayor Rahm Emanuel poses for a picture with mayors from the U.S., Mexico and Canada during the North American Climate Summit on Tuesday.

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Mayors from across the country say a lack of leadership in Washington on climate change is prompting them to take action themselves.

About 50 mayors from cities large and small wrapped up a climate change summit in Chicago Wednesday, where they signed a formal agreement to reduce greenhouse gas emissions in their cities. They also agreed to meet goals similar to those in the Paris climate accord, which President Trump announced earlier this year the U.S. would withdraw from.

Former President Barack Obama, who signed onto the Paris agreement in 2015, lended his support to the mayors’ actions in a speech to the North American Climate Summit Tuesday afternoon.

Obama pointed to rising sea levels, worsening droughts and storms and rising global temperatures as irrefutable evidence that the climate is changing.

“Miami already floods on sunny days,” Obama said. “Western cities across North American are dealing with longer and harsher wild fire seasons. A conveyor belt of some of the strongest hurricanes on record this summer smashed into Houston and Florida and Puerto Rico and more than two months later they are still struggling to recover.”

“Obviously we’re in an unusual time when the United States is now the only nation on Earth that does not belong to the Paris agreement,” Obama continued. “And that’s a difficult position to defend. But the good news is that the Paris agreement was never going to solve the climate crisis on its own. It was going to be up to all of us.”

Obama told the told the mayors attending the summit that they are America’s new front-line leaders on climate change. He said the most important work addressing climate change isn’t being done at the level of national leaders, but is being done on the ground.

“And cities and states and businesses and universities and non-profits have emerged as the new face of American leadership on climate change.”

Mayors from cities in Mexico and Canada joined their U.S. counterparts in committing to reducing carbon emissions.

“We stand shoulder to shoulder with all of the U.S. cities and mayors that are committed to the Paris agreement,” said Vancouver Mayor Gregor Robertson, who added that President Trump should listen to the mayors on the issue of climate change. “We’re on that path and we know our American sisters and brothers are. We just hope the president of the United States wakes up” and recognizes the importance of addressing climate change.

“There is an absence of leadership out of Washington,” said Chicago Mayor Rahm Emanuel, who served as President Obama’s chief of staff. “As it relates to climate change, we can’t afford as leaders of our respective cities for the absence of leadership and the wrongheadedness of policy by President Trump. Can’t afford it.”

Emanuel says the participating mayors are filling a leadership void created by Trump by signing a first-of-it’s-kind international charter agreement aligned to the Paris climate agreement that commits their cities to reducing greenhouse gas emissions that cause global warming and outlines specific plans for meeting the carbon emission reduction targets by 2025.

“You may withdraw,” says Emanuel, referring to Trump pulling out of the Paris agreement. “But we’re all in on the Paris protocols.”

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Design Miami Features Affordable Collectible Design

The contemporary art market has become so expensive that only the wealthiest people can participate. For those who want to collect art but can’t afford a famous artist’s work, a less expensive alternative is collectible design which includes objects, furniture, ceramics, lighting and everyday items. This week, designers, galleries and collectors gather for Design Miami, the premiere international design fair.

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