Cervical cancer risk and use of depot-medroxyprogesterone acetate in Costa Rica
Oberle, M.W.; Rosero-Bixby, L.; Irwin, K.L.; Fortney, J.A.; Lee, N.C.; Whatley, A.S.; Bonhomme, M.G.
International Journal of Epidemiology 17(4): 718-723
1988
ISSN/ISBN: 0300-5771 PMID: 2976059 DOI: 10.1093/ije/17.4.718Document Number: 362480
A nationwide case-control study was conducted in Costa Rica in 1984-85 to examine the association between depot-medroxyprogesterone acetate (DMPA) and cervical cancer. Cases, restricted to women 25-58 years of age at the time of diagnosis, were women with invasive squamous cell cancer (n = 149) or carcinoma in situ (CIS, n=415) reported by the National Tumor Registry during 1982-84. The 764 controls were randomly selected during a nationwide household survey. On average, the CIS cases were younger than controls; the invasive cases were older than controls. Both case groups were more likely than controls to be of low socioeconomic status, to have become sexually active at a young age, to report a history of a sexually transmitted disease or pelvic inflammatory disease, and to report having 3 or more partners in their lifetime. Ever users of DMPA had a risk of CIS of 1.1 when compared with never users. Women who 1st used DMPA before age 30 had a CIS risk of 0.6 whereas users who began use after age 39 had a risk of 2.0. Both of these risk estimates were based on small numbers of users. Ever users of DMPA had a risk of invasive cancer of 1.4 when compared with never users, but all estimates for invasive cancer were based on only 10 cases who reported use of DMPA. Few of the women had used DMPA for longer than 2 years.