Ever-Use of the Intra-Uterine Contraceptive Device and the Risk of Ovarian Cancer: A Systematic Review and Meta-Analysis
CANSAGE ePoster Library. Gil Y. 09/26/19; 279822; eP-140
Dr. Yaron Gil
Dr. Yaron Gil
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Objectives: Exposure to oral hormonal contraceptives during reproductive years is associated with a decreased risk of ovarian cancer. However, the association between the use of the intra-uterine device (IUD) and the risk of ovarian cancer is less well known. In this study, we sought to determine whether the use of an IUD is associated with a reduction in the risk of ovarian cancer.
Methods: We searched Medline, EMBASE, Google Scholar, Scopus, ISI Web of Science and Cochrane database search, as well as PubMed (www.pubmed.gov) and RCT registry (www.clinicaltrials.gov) until the end of June 2019 to conduct a systematic review and meta-analysis comparing ever-use vs. never-use of an IUD and the risk of subsequent ovarian cancer.
Results: We obtained 431 records, of which 9 met inclusion criteria. A total of 5 case-control studies and 4 cohort studies were retrieved to establish the risk of ovarian cancer amongst ever-users of an IUD. Relative to the never-use of the IUD, ever-use conferred a lower risk of ovarian cancer with an estimated OR of 0.67 95% CI [0.60 – 0.74], p<0.0001, I2 = 71%. This relationship remained significant when results were restricted to studies evaluating the levonorgestrel intrauterine system (LNG-IUD) alone, with an estimated OR of 0.58 95% CI [0.47 – 0.71], p<0.0001, I2 = 0%, as well as when the analysis was stratified by study design, with an OR of 0.64 95% CI [0.56 – 0.74] for case-control studies, and OR of 0.71 95% CI [0.60 – 0.84] for cohort studies (p<0.0001).
Conclusion: Ever-use of an intrauterine contraceptive device reduces the risk of ovarian cancer by an average of 30%. Whether differences exist for duration of use, use of type-specific device, and specific tumor type needs to be addressed in future studies.
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