IUDs tied to lower risk for cervical cancer

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Takeaway

  • Women using an intrauterine device (IUD) for birth control have a significantly reduced risk for cervical cancer (CC).
  • The benefit is more prominent in populations with high CC incidence and limited access to screening.

Why this matters

  • IUD-related changes in local mucosa - a low-grade inflammatory response - may alter the course of HPV infection.
  • Further studies are needed before IUDs can be recommended as a preventive measure.

Study design

  • This meta-analysis evaluated 16 high-quality studies involving 4945 cases of CC and 7537 control cases.
  • One study that could not be harmonized for meta-analysis was analyzed separately.
  • Funding: University of Southern California Keck School of Medicine, National Cancer Institute.

Key results

  • Overall risk for CC was lower in women who used IUD (OR, 0.64; 95% CI, 0.53-0.77).
  • The separate study showed reduced risk for CC with 2-9 y (OR, 0.6; 95% CI, 0.3-1.2) and ≥10 y of IUD use (OR, 0.9; 95% CI, 0.1-1.3).
  • An inverse correlation was observed between the natural logarithm of OR values from individual studies and both HPV prevalence and lower access to screening (age-adjusted incidence rate coefficient, -0.014; P=.005).

Limitations

  • Moderate heterogeneity (I2=42.5%).
  • Influence of hormonal vs copper IUD not evaluated.
  • Variable HPV prevalence.