Protective association not seen for women testing positive for human papillomavirus
TUESDAY, Sept. 13 (HealthDay News) -- Intrauterine device (IUD) use is associated with a lower risk of cervical cancer, but the protective association is not seen in human papillomavirus (HPV)-positive women, according to a study published online Sept. 13 in The Lancet Oncology.
Xavier Castellsagué, M.D., from L'Hospitalet de Llobregat in Catalonia, Spain, and colleagues investigated the effects of IUD use on HPV infection and the risk of developing cervical cancer. Data from two large studies, one with 10 case-control studies of cervical cancer from eight countries, and the other with 16 HPV surveys from 14 countries, were analyzed. A total of 2,205 women with cervical cancer and 2,214 matched control women without cervical cancer were included from the case-control studies, and 15,272 healthy women from the HPV surveys. IUD use was determined by interview. Polymerase chain reaction-based assays were used to test for HPV DNA.
The investigators found a significant inverse association between ever use of IUDs and cervical cancer (odds ratio, 0.55), after adjusting for covariates, including cervical HPV DNA and number of previous Papanicolaou smears. A significant protective association was found for squamous-cell carcinoma, adenocarcinoma, and adenosquamous carcinoma, but not in HPV-positive women. IUD use was not associated with detection of cervical HPV DNA in women without cervical cancer.
"Our data suggest that use of IUDs substantially reduces the risk of cervical cancer and that this effect does not seem to be due to differences in screening histories between users and non-users," the authors write.
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