Ovarian cancer is the most lethal of all gynecologic malignancies accounting for more than more than 22,000 deaths worldwide annually [1]. In the US, it is estimated that there will be 22,530 new cases and 13,980 deaths due to ovarian cancer in 2019 [2]. Combined oral contraceptives (OCPs, a once-daily pill taken orally) have long been shown to decrease the risk of ovarian cancer [3-4]. However, the need to remember to take a pill every day makes long-acting reversible contraceptives (LARCs) like the intrauterine device (IUD) both easier to use and more reliable.
IUDs have long been championed for their 99% efficacy at preventing pregnancy as well as the fact that they last 3-12 years depending on the type. Not only do IUDs prevent pregnancy, but they have also been linked to a reduced risk of endometrial cancer [4]. This is most likely due to the IUD’s induction of a number of immunological and biochemical changes in the uterine environment that fight cells that may lead to cancer. The link to a reduction in endometrial cancer risk is a huge bonus to IUD use, which already has many advantages for women who want to prevent pregnancy long-term without needing to take a pill or get an injection regularly like other forms of birth control.
To make IUDs even more enticing, a study published this month in the Green Journal, one of the most influential journals in Obstetrics & Gynecology and women’s health, showed that IUDs may also reduce the risk of ovarian cancer [5]. This study, conducted at the University of Colorado School of Medicine, included a systematic review and meta-analysis using several databases including Medline and the Cochrane Library. Eleven studies with original data regarding IUD use and the incidence of ovarian cancer were used for meta-analysis. The study found that IUD use is associated with a reduced incidence of ovarian cancer. A setback to this study is its retrospective nature. A prospective investigation into the role of IUDs in ovarian cancer is needed in future work.
Combined OCPs used to be the only form of birth control linked to a reduction in ovarian cancer risk. However, now that IUDs are known to reduce the risk of both endometrial and ovarian cancer, as well as being a LARC, they are superior to OCPs in many aspects. Depending on a women’s personal preference, IUDs offer a great long-term contraceptive with these additional benefits. Healthcare providers and patients alike can celebrate this milestone in family planning while continuing to outweigh the risks and benefits of all birth control methods for each individual.
ORCHID ABAR, DUCOM Class of 2020
References
1. Jayson GC, Kohn EC, Kitchener HC, Ledermann JA. Ovarian cancer. Lancet 2014;384:1376–88.
2. National Cancer Institute, Surveillance, Epidemiology, and End Results Program. Cancer stat facts: ovarian cancer. Available at: https://seer.cancer.gov/statfacts/html/ovary.html.
3. Bahamondes L, Valeria Bahamondes M, Shulman LP. Noncontraceptive benefits of hormonal and intrauterine reversible contraceptive methods. Hum Reprod Update 2015;21:640–51.
5. Felix AS, Gaudet MM, La Vecchia C, et al. Intrauterine devices and endometrial cancer risk: a pooled analysis of the Epidemiology of Endometrial Cancer Consortium. Int J Cancer .2015;136(5):E410–E422. doi:10.1002/ijc.29229
6. Wheeler LJ, Desanto K, Teal SB, Sheeder J, Guntupalli SR. Intrauterine Device Use and Ovarian Cancer Risk. Obstet Gynecol . September 2019:1.
