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Meta-Analysis
. 2017 Dec;130(6):1226-1236.
doi: 10.1097/AOG.0000000000002307.

Intrauterine Device Use and Cervical Cancer Risk: A Systematic Review and Meta-analysis

Victoria K Cortessis  1 , Malcolm Barrett, Niquelle Brown Wade, Temuulen Enebish, Judith L Perrigo, Jessica Tobin, Charlie Zhong, Jennifer Zink, Vanessa Isiaka, Laila I Muderspach, Melissa Natavio, Roberta McKean-Cowdin
Affiliations
Meta-Analysis

Intrauterine Device Use and Cervical Cancer Risk: A Systematic Review and Meta-analysis

Victoria K Cortessis et al. Obstet Gynecol. 2017 Dec.

Abstract

Objective: To estimate the association between use of an intrauterine device (IUD) and risk of cervical cancer by subjecting existing data to critical review, quantitative synthesis, and interpretation.

Data sources: We searched PubMed, Web of Science, ClinicalTrials.gov, and catalogs of scientific meetings and abstracts, theses, and dissertations queried from inception through July 2016.

Methods of study selection: Examination of abstracts from 225 reports identified 34 studies with individual-level measures of use of an IUD and incident cervical cancer. By critically assessing the full text of these reports, independent reviewers identified 17 studies conducted without recognized sources of systematic error, of which 16 could be harmonized for meta-analysis.

Tabulation, integration, and results: Point and interval estimates of the association between use of an IUD and incident cervical cancer were extracted from original reports into a structured database along with key features of study design and implementation. A random-effects meta-analysis was implemented to quantitatively synthesize extracted estimates and assess likely influence of publication bias, residual confounding, heterogeneity of true effect size, and human papillomavirus prevalence and cervical cancer incidence in source populations. Women who used an IUD experienced less cervical cancer (summary odds ratio 0.64, 95% CI 0.53-0.77). Neither confounding by recognized risk factors nor publication bias seems a plausible explanation for the apparent protective effect, which may be stronger in populations with higher cervical cancer incidence.

Conclusion: Invasive cervical cancer may be approximately one third less frequent in women who have used an IUD. This possible noncontraceptive benefit could be most beneficial in populations with severely limited access to screening and concomitantly high cervical cancer incidence.

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References

    1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:E359–86.
    1. Peto J, Gilham C, Fletcher O, Matthews FE. The cervical cancer epidemic that screening has prevented in the UK. Lancet 2004;364:249–56.
    1. Beavis AL, Gravitt PE, Rositch AF. Hysterectomy-corrected cervical cancer mortality rates reveal a larger racial disparity in the United States. Cancer 2017;123:1044–50.
    1. Haile RW, John EM, Levine AJ, Cortessis VK, Unger JB, Gonzales M, et al. A review of cancer in U.S. Hispanic populations. Cancer Prev Res 2012;5:150–63.
    1. Bruni L, Diaz M, Barrionuevo-Rosas L, Herrero R, Bray F, Bosch FX, et al. Global estimates of human papillomavirus vaccination coverage by region and income level: a pooled analysis. Lancet Glob Health 2016;4:e453–63.

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