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Depot-Medroxyprogesterone Acetate Use Is Associated with Decreased Risk of Ovarian Cancer: The Mounting Evidence of a Protective Role of Progestins.

Publication ,  Journal Article
Phung, MT; Lee, AW; Wu, AH; Berchuck, A; Cho, KR; Cramer, DW; Doherty, JA; Goodman, MT; Hanley, GE; Harris, HR; McLean, K; Modugno, F ...
Published in: Cancer Epidemiol Biomarkers Prev
May 2021

BACKGROUND: Combined oral contraceptive use is associated with a decreased risk of invasive epithelial ovarian cancer (ovarian cancer). There is suggestive evidence of an inverse association between progestin-only contraceptive use and ovarian cancer risk, but previous studies have been underpowered. METHODS: The current study used primary data from 7,977 women with ovarian cancer and 11,820 control women in seven case-control studies from the Ovarian Cancer Association Consortium to evaluate the association between use of depot-medroxyprogesterone acetate (DMPA), an injectable progestin-only contraceptive, and ovarian cancer risk. Logistic models were fit to determine the association between ever use of DMPA and ovarian cancer risk overall and by histotype. A systematic review of the association between DMPA use and ovarian cancer risk was conducted. RESULTS: Ever use of DMPA was associated with a 35% decreased risk of ovarian cancer overall (OR, 0.65; 95% confidence interval, 0.50-0.85). There was a statistically significant trend of decreasing risk with increasing duration of use (P trend < 0.001). The systematic review yielded six studies, four of which showed an inverse association and two showed increased risk. CONCLUSIONS: DMPA use appears to be associated with a decreased risk of ovarian cancer in a duration-dependent manner based on the preponderance of evidence. Further study of the mechanism through which DMPA use is associated with ovarian cancer is warranted. IMPACT: The results of this study are of particular interest given the rise in popularity of progestin-releasing intrauterine devices that have a substantially lower progestin dose than that in DMPA, but may have a stronger local effect.

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Published In

Cancer Epidemiol Biomarkers Prev

DOI

EISSN

1538-7755

Publication Date

May 2021

Volume

30

Issue

5

Start / End Page

927 / 935

Location

United States

Related Subject Headings

  • Risk Assessment
  • Progestins
  • Ovarian Neoplasms
  • Middle Aged
  • Medroxyprogesterone Acetate
  • Humans
  • Female
  • Epidemiology
  • Contraceptive Agents, Hormonal
  • Case-Control Studies
 

Citation

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Phung, M. T., Lee, A. W., Wu, A. H., Berchuck, A., Cho, K. R., Cramer, D. W., … Australian Ovarian Cancer Study Group and the Ovarian Cancer Association Consortium, . (2021). Depot-Medroxyprogesterone Acetate Use Is Associated with Decreased Risk of Ovarian Cancer: The Mounting Evidence of a Protective Role of Progestins. Cancer Epidemiol Biomarkers Prev, 30(5), 927–935. https://doi.org/10.1158/1055-9965.EPI-20-1355
Phung, Minh Tung, Alice W. Lee, Anna H. Wu, Andrew Berchuck, Kathleen R. Cho, Daniel W. Cramer, Jennifer Anne Doherty, et al. “Depot-Medroxyprogesterone Acetate Use Is Associated with Decreased Risk of Ovarian Cancer: The Mounting Evidence of a Protective Role of Progestins.Cancer Epidemiol Biomarkers Prev 30, no. 5 (May 2021): 927–35. https://doi.org/10.1158/1055-9965.EPI-20-1355.
Phung MT, Lee AW, Wu AH, Berchuck A, Cho KR, Cramer DW, et al. Depot-Medroxyprogesterone Acetate Use Is Associated with Decreased Risk of Ovarian Cancer: The Mounting Evidence of a Protective Role of Progestins. Cancer Epidemiol Biomarkers Prev. 2021 May;30(5):927–35.
Phung, Minh Tung, et al. “Depot-Medroxyprogesterone Acetate Use Is Associated with Decreased Risk of Ovarian Cancer: The Mounting Evidence of a Protective Role of Progestins.Cancer Epidemiol Biomarkers Prev, vol. 30, no. 5, May 2021, pp. 927–35. Pubmed, doi:10.1158/1055-9965.EPI-20-1355.
Phung MT, Lee AW, Wu AH, Berchuck A, Cho KR, Cramer DW, Doherty JA, Goodman MT, Hanley GE, Harris HR, McLean K, Modugno F, Moysich KB, Mukherjee B, Schildkraut JM, Terry KL, Titus LJ, Jordan SJ, Webb PM, Pike MC, Pearce CL, Ovarian Cancer Association Consortium, Australian Ovarian Cancer Study Group and the Ovarian Cancer Association Consortium. Depot-Medroxyprogesterone Acetate Use Is Associated with Decreased Risk of Ovarian Cancer: The Mounting Evidence of a Protective Role of Progestins. Cancer Epidemiol Biomarkers Prev. 2021 May;30(5):927–935.

Published In

Cancer Epidemiol Biomarkers Prev

DOI

EISSN

1538-7755

Publication Date

May 2021

Volume

30

Issue

5

Start / End Page

927 / 935

Location

United States

Related Subject Headings

  • Risk Assessment
  • Progestins
  • Ovarian Neoplasms
  • Middle Aged
  • Medroxyprogesterone Acetate
  • Humans
  • Female
  • Epidemiology
  • Contraceptive Agents, Hormonal
  • Case-Control Studies