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One study found a 10% increased risk for less than 5 years of use, a 60% increased risk with 59 years of use, and a doubling of the risk with 10 or more years of use (9)

(including ENDS) to 21 (Carlisle, 2020)

Friedberg said

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It may be mistaken for a pimple or hidden from view inside the vagina or rectum