OBJECTIVE: To evaluate the effect of depot medroxyprogesterone acetate (DMPA) in protecting against epithelial ovarian cancer (EOC) and to evaluate factors associated with the risk of EOC. DESIGN: A multicentre, case-control study. SETTING: Twelve hospitals located across Thailand. POPULATION: Three hundred and thirty patients with EOC ('cases') and 982 matched controls were recruited from the 12 hospitals. Cases were newly diagnosed patients with EOC, demonstrated pathologically. Controls were age-matched patients admitted to different wards in the same hospital. METHODS: Cases and controls were interviewed by trained interviewers using a standardised pre-tested questionnaire. The factors associated with EOC were evaluated using univariate and multivariate analyses. MAIN OUTCOME MEASURES: The odds ratio (OR) and 95% confidence interval (95% CI) were calculated to assess the relationship between DMPA and EOC. RESULTS: The use of DMPA was found to be associated with a 39% reduction in the risk of EOC with an OR of 0.61 and a 95% CI of 0.44-0.85 (P = 0.002). A significant risk reduction (83%) was observed when the duration of DMPA use was >3 years (OR 0.17; 95% CI 0.07-0.39; P < 0.001). Other factors associated with a reduced risk of EOC were the use of combined oral contraceptive pills and breastfeeding. A factor associated with an increased risk of EOC was a family history of gynaecological cancer. CONCLUSIONS: The results suggest that DMPA may have a protective effect against EOC. If this effect is real, then it represents an important non-contraceptive benefit of DMPA.
OBJECTIVE: To evaluate the effect of depot medroxyprogesterone acetate (DMPA) in protecting against epithelial ovarian cancer (EOC) and to evaluate factors associated with the risk of EOC. DESIGN: A multicentre, case-control study. SETTING: Twelve hospitals located across Thailand. POPULATION: Three hundred and thirty patients with EOC ('cases') and 982 matched controls were recruited from the 12 hospitals. Cases were newly diagnosed patients with EOC, demonstrated pathologically. Controls were age-matched patients admitted to different wards in the same hospital. METHODS: Cases and controls were interviewed by trained interviewers using a standardised pre-tested questionnaire. The factors associated with EOC were evaluated using univariate and multivariate analyses. MAIN OUTCOME MEASURES: The odds ratio (OR) and 95% confidence interval (95% CI) were calculated to assess the relationship between DMPA and EOC. RESULTS: The use of DMPA was found to be associated with a 39% reduction in the risk of EOC with an OR of 0.61 and a 95% CI of 0.44-0.85 (P = 0.002). A significant risk reduction (83%) was observed when the duration of DMPA use was >3 years (OR 0.17; 95% CI 0.07-0.39; P < 0.001). Other factors associated with a reduced risk of EOC were the use of combined oral contraceptive pills and breastfeeding. A factor associated with an increased risk of EOC was a family history of gynaecological cancer. CONCLUSIONS: The results suggest that DMPA may have a protective effect against EOC. If this effect is real, then it represents an important non-contraceptive benefit of DMPA.
Authors: Minh Tung Phung; Alice W Lee; Anna H Wu; Andrew Berchuck; Kathleen R Cho; Daniel W Cramer; Jennifer Anne Doherty; Marc T Goodman; Gillian E Hanley; Holly R Harris; Karen McLean; Francesmary Modugno; Kirsten B Moysich; Bhramar Mukherjee; Joellen M Schildkraut; Kathryn L Terry; Linda J Titus; Susan J Jordan; Penelope M Webb; Malcolm C Pike; Celeste Leigh Pearce Journal: Cancer Epidemiol Biomarkers Prev Date: 2021-02-22 Impact factor: 4.090
Authors: Ana Babic; Naoko Sasamoto; Bernard A Rosner; Shelley S Tworoger; Susan J Jordan; Harvey A Risch; Holly R Harris; Mary Anne Rossing; Jennifer A Doherty; Renée T Fortner; Jenny Chang-Claude; Marc T Goodman; Pamela J Thompson; Kirsten B Moysich; Roberta B Ness; Susanne K Kjaer; Allan Jensen; Joellen M Schildkraut; Linda J Titus; Daniel W Cramer; Elisa V Bandera; Bo Qin; Weiva Sieh; Valerie McGuire; Rebecca Sutphen; Celeste L Pearce; Anna H Wu; Malcolm Pike; Penelope M Webb; Francesmary Modugno; Kathryn L Terry Journal: JAMA Oncol Date: 2020-06-11 Impact factor: 33.006