Intrauterine device may be protective against cervical cancer

January 01, 0001

Intrauterine device may be protective against cervical cancer

Intrauterine device (IUD) use has been shown to reduce the risk of endometrial cancer, but little is known about its association with cervical cancer risk. The researchers from Spain, France and The Netherlands assessed whether IUD use affects cervical human papillomavirus (HPV) infection and the risk of developing cervical cancer. They did a pooled analysis of individual data from two large studies by the International Agency for Research on Cancer and Institut Català d'Oncologia research programme on HPV and cervical cancer; one study included data from ten case—control studies of cervical cancer done in eight countries, and the other included data from 16 HPV prevalence surveys of women from the general population in 14 countries. 2205 women with cervical cancer and 2214 matched control women without cervical cancer were included from the case—control studies, and 15 272 healthy women from the HPV surveys. Information on IUD use was obtained by personal interview.

After adjusting for relevant covariates, including cervical HPV DNA and number of previous Papanicolaou smears, a strong inverse association was found between ever use of IUDs and cervical cancer (odds ratio 0·55). A protective association was noted for squamous-cell carcinoma (0·56), adenocarcinoma and adenosquamous carcinoma (0·46), but not among HPV-positive women (0·68, not significant). No association was found between IUD use and detection of cervical HPV DNA among women without cervical cancer.

The researchers concluded: "Our data suggest that IUD use might act as a protective cofactor in cervical carcinogenesis. Cellular immunity triggered by the device might be one of several mechanisms that could explain our findings."

Again, think of cofounders.

For the full abstract, click here.

The Lancet Oncology published online 13 September 2011 © 2011 Elsevier Ltd
Intrauterine device use, cervical infection with human papillomavirus, and risk of cervical cancer: a pooled analysis of 26 epidemiological studies. Xavier Castellsagué, Mireia Díaz, Salvatore Vaccarella et al. Correspondence to Xavier Castellsagué: xcastellsague@iconcologia.net

Category: W. Pregnancy/Childbirth/Family Planning, X. Female Genital System, Breast. Keywords: intrauterine device, cervical, infection, cancer, human papillomavirus, pooled analysis, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 7 October 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.