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

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • 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,

Published Date

  • May 1, 2021

Published In

Volume / Issue

  • 30 / 5

Start / End Page

  • 927 - 935

PubMed ID

  • 33619020

Pubmed Central ID

  • PMC9281627

Electronic International Standard Serial Number (EISSN)

  • 1538-7755

Digital Object Identifier (DOI)

  • 10.1158/1055-9965.EPI-20-1355

Language

  • eng

Conference Location

  • United States