Sturgeon S R, Brinton L A, Berman M L, Mortel R, Twiggs L B, Barrett R J, Wilbanks G D, Lurain J R
Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland 20852, USA.
Int J Epidemiol. 1997 Jun;26(3):496-500. doi: 10.1093/ije/26.3.496.
Because intrauterine devices (IUD) invoke acute and chronic inflammatory responses in the endometrium, it is possible that prolonged insertion of an IUD could induce endometrial cancer.
We examined the relation between use of an IUD and endometrial cancer risk using data from a multicentre case-control study involving 405 endometrial cancer cases and 297 population controls.
A total of 20 (4.9%) cases and 34 (11.4%) controls reported any use of an IUD. After adjustment for potential confounders, IUD use was not associated with an increased risk of endometrial cancer (RR = 0.56 for ever use; 95% CI: 0.3-1.0). Little reduction in risk was observed among women who last used an IUD within 10 years of the index date (RR = 0.84; 95% CI: 0.3-2.4) but risk was decreased among women who used an IUD in the more distant past (RR = 0.45; 95% CI: 0.2-1.0). Risk did not vary consistently with number of years of IUD use or with years since first use. Risk was not increased among women who used inert devices (RR = 0.46; 95% CI: 0.3-3.6) or those who used devices containing copper (RR = 1.08; 95% CI: 0.1-3.6).
These data are reassuring in that they do not provide any evidence of an increased risk of endometrial cancer among women who have used IUD.
由于宫内节育器（IUD）会引发子宫内膜的急性和慢性炎症反应，长期放置IUD有可能诱发子宫内膜癌。
我们利用一项多中心病例对照研究的数据，探讨了IUD使用与子宫内膜癌风险之间的关系，该研究纳入了405例子宫内膜癌病例和297名人群对照。
共有20例（4.9%）病例和34名对照（11.4%）报告曾使用过IUD。在对潜在混杂因素进行调整后，IUD使用与子宫内膜癌风险增加无关（曾经使用的相对风险RR = 0.56；95%置信区间CI：0.3 - 1.0）。在索引日期前10年内最后使用IUD的女性中，风险降低不明显（RR = 0.84；95% CI：0.3 - 2.4），但在过去更久之前使用IUD的女性中风险降低（RR = 0.45；95% CI：0.2 - 1.0）。风险与IUD使用年限或首次使用后的年限并无一致变化。使用惰性节育器的女性（RR = 0.46；95% CI：0.3 - 3.6）或使用含铜节育器的女性（RR = 1.08；95% CI：0.1 - 3.6）中风险并未增加。
这些数据令人安心，因为它们并未提供任何证据表明使用IUD的女性患子宫内膜癌的风险增加。
