Birth control pills and device tied to high-grade cervical neoplasia risk

  • Loopik DL & al.
  • Eur J Cancer
  • 21 Nov 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • The use of oral contraceptives and intrauterine devices (IUDs) was associated with an increased risk of developing cervical intraepithelial neoplasia grade III or worse (CIN3+) vs no contraception.
  • The risk for CIN3+ was higher with oral contraceptives vs IUDs.

Why this matters

  • A pooled analysis of epidemiological studies suggested IUD use may be a protective cofactor in the risk for cervical cancer.

Study design

  • 702,037 women aged 29-44 years attended a cervical cancer screening program with normal cytology during 2005-2009.
  • Funding: None.

Key results

  • 0.96% of women developed CIN3, and 0.08% were diagnosed with cervical cancer during median follow-up of 9.7 years.
  • 25.4% of women used no contraceptive, 12.2% used oral contraceptives, and 3.9% used an IUD for ≥5 years.
  • IUD use was associated with an increased risk of developing CIN3+ (risk ratio [RR], 1.51; 95% CI, 1.32-1.74), but not the risk for cervical cancer (RR, 1.21; 95% CI, 0.71-2.07) vs no contraception.
  • Oral contraceptives were associated with an increased risk for CIN3+ (RR, 2.77; 95% CI, 2.65-3.00) and cervical cancer (RR, 2.06; 95% CI, 1.52-2.79) vs no contraception.
  • Use of oral contraceptives was associated with a higher risk for CIN3+ (RR, 1.83; 95% CI, 1.60-2.09) and cervical cancer (RR, 1.70; 95% CI, 1.00-2.90) vs IUDs.
  • Women who did not use any type of contraceptive showed a significantly lower risk for CIN3+ (RR, 0.61; 95% CI, 0.58-0.64) and cervical cancer (RR, 0.63; 95% CI, 0.53-0.75) vs the total group.

Limitations

  • Observational design.