Invasive Cervical Cancer Risk No Greater for DMPA Users Than for Nonusers

Abstract

The findings of a World Health Organization (WHO) case-control study conducted in Kenya Mexico and Thailand suggest that Depo-Provera users are at no greater risk of invasive cervical cancer than non-users (relative risk 1.1) regardless of duration of use. Women who had used Depo-Provera for 4-8 years were only 10% more likely than non-users to develop cervical cancer and there was no elevation in risk among women who received their first injection more than 12 years before the interview. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives compared 2009 cervical cancer patients with 9583 controls hospitalized for non-gynecologic conditions. In the Thai and Mexican studies the cervical cancer risk was slightly but not significantly elevated among women with a history of anal or genital warts (relative risks 1.24 and 1.61 respectively) but significantly increased among those with herpes simplex type 2 antibodies (relative risk 1.67). However these history variables as well as husbands sexual behavior had no confounding effect on the association between Depo-Provera use and cervical cancer. There was no alteration in cancer risk among Depo-Provera users according to oral contraceptive use sexually transmitted disease history herpes antibody status age at first intercourse or husbands exposure to prostitutes.