Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.
Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Int J Cancer. 2021 Jul 1;149(1):75-83. doi: 10.1002/ijc.33531. Epub 2021 Mar 17.
Results of studies assessing intrauterine device (IUD) use and ovarian cancer risk are inconsistent. We examined the association between IUD use, including duration, type and timing of use, and ovarian cancer risk using three population-based studies. Data from the New England Case-Control Study (NEC) and two prospective cohort studies, the Nurses' Health Studies (NHS/NHSII), were included in the analysis. Information on IUD use was collected by in-person interview in NEC and by biennial questionnaire in NHS/NHSII. We used unconditional logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI) in NEC and Cox regression to calculate hazard ratios (HR) and 95% CI in NHS/NHSII. We used meta-analysis to combine the NEC and the pooled NHS/NHSII results. Overall, IUD use was not associated with epithelial ovarian cancer risk (OR = 0.96, 95% CI: 0.81-1.14 in NEC; HR = 0.89, 95% CI: 0.69-1.15 in NHS/NHSII; combined RR = 0.94, 95% CI: 0.81-1.08). Among IUD users, older age at first use was associated with increased ovarian cancer risk (P-trend = .03). We did not observe significant associations by IUD type or duration of use. In conclusion, IUD use was not associated with ovarian cancer risk in our study.
研究评估宫内节育器(IUD)使用与卵巢癌风险的结果不一致。我们使用三项基于人群的研究检查了 IUD 使用与卵巢癌风险之间的关联,包括使用时间、类型和时机。新英格兰病例对照研究(NEC)和两项前瞻性队列研究,护士健康研究(NHS/NHSII)的数据包括在分析中。IUD 使用信息通过 NEC 中的个人访谈和 NHS/NHSII 中的每两年一次的问卷调查收集。我们使用无条件逻辑回归计算 NEC 中的优势比(OR)和 95%置信区间(CI),并使用 Cox 回归计算 NHS/NHSII 中的风险比(HR)和 95%CI。我们使用荟萃分析合并 NEC 和汇总 NHS/NHSII 结果。总体而言,IUD 使用与上皮性卵巢癌风险无关(NEC 中的 OR = 0.96,95%CI:0.81-1.14;NHS/NHSII 中的 HR = 0.89,95%CI:0.69-1.15;合并 RR = 0.94,95%CI:0.81-1.08)。在 IUD 用户中,首次使用时年龄较大与卵巢癌风险增加相关(P 趋势=0.03)。我们没有观察到 IUD 类型或使用时间与卵巢癌风险之间存在显著关联。总之,在我们的研究中,IUD 使用与卵巢癌风险无关。