期刊
GYNECOLOGIC ONCOLOGY
卷 149, 期 1, 页码 127-132出版社
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ygyno.2018.02.006
关键词
Epidemiology; Prospective cohort study; Ovarian neoplasms; Uterine neoplasms; Breast neoplasms; Intrauterine device; Intrauterine device, medicated; Levonorgestrel; Levonorgestrel-releasing intrauterine system; Hormonal contraceptives
资金
- Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway
Objective. Women with ovarian cancer have poor survival rates, which have proven difficult to improve; therefore primary prevention is important. The levonorgestrel-releasing intrauterine system (LNG-IUS) prevents endometrial cancer, and recent studies suggested that it may also prevent ovarian cancer, but with a concurrent increased risk of breast cancer. We compared adjusted risks of ovarian, endometrial, and breast cancer in ever users and never users of LNG-IUS. Methods Our study cohort consisted of 104,318 women from the Norwegian Women and Cancer Study, 9144 of whom were ever users and 95,174 of whom were never users of LNG-IUS. Exposure information was taken from self-administered questionnaires, and cancer cases were identified through linkage to the Cancer Registry of Norway. Relative risks (RRs) with 95% confidence intervals (CIs) were estimated with Poisson regression using robust error estimates. Results. Median age at inclusion was 52 years and mean follow-up time was 12.5 (standard deviation 3.7) years, for a total of 1305,435 person-years. Among ever users of LNG-IUS there were 18 cases of epithelial ovarian cancer, 15 cases of endometrial cancer, and 297 cases of breast cancer. When ever users were compared to never users of LNG-IUS, the multivariable RR of ovarian, endometrial, and breast cancer was 0.53 (95% CI: 032, 0.88), 022 (0.13, 0.40), and 1.03 (0.91, 1.17), respectively. Conclusion. In this population-based prospective cohort study, ever users of LNG-IUS had a strongly reduced risk of ovarian and endometrial cancer compared to never users, with no increased risk of breast cancer. (C) 2017 Elsevier Inc. All rights reserved.
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