Clinical Edge

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Recent IUD Use and Risk of Cervical Cancer

Contraception; ePub 2018 Apr 16; Averbach, et al

Recent levonorgestrel intrauterine device (IUD) use may be associated with cervical intraepithelial neoplasia 2 (CIN2+), a lesion with a high rate of regression, but not CIN3+, which is considered a true pre-cancerous lesion. This according to a case-control study of 17,559 women aged 18 to 49 years with incident CIN2+ cases and 5:1 age-matched, incidence-density selected controls (n=87,378) from 1996-2014. Recent IUD use, within 18 months prior to index, was the exposure of interest. Among the findings:

  • 1,657 IUD users were identified among the cases and 7,925 IUD users among controls.
  • After adjustment, IUD use was associated with an increased rate of CIN2+ (rate ratio [RR] 1.12), but not CIN3+ (RR, 1.02).
  • Levonorgestrel-IUD use was associated with an increased rate of CIN2+ (RR, 1.18), but not CIN3+ (RR, 1.05).
  • Copper-IUD use was not associated with CIN2+ (RR, 0.88) or CIN3+ (RR, 0.81).

Averbach S, Silverberg MJ, Leyden W, et al. Recent intrauterine device use and the risk of precancerous cervical lesions and cervical cancer. [Published online ahead of print April 16, 2018]. Contraception. doi:10.1016/j.contraception.2018.04.008.