FSRH CEU Statement: Response to Study on Intrauterine Contraception Use and Cervical Cancer Risk

This statement responds to a recent study that reported that women who had used intrauterine contraception (IUC) were over one third less likely to experience invasive cervical cancer than women who had not used IUC. The study has received media attention and the FSRH CEU considered it important to put the findings into perspective.

A systematic review and meta-analysis published in Obstetrics and Gynecology reported that women who had used intrauterine contraception (IUC) were over one third less likely to experience invasive cervical cancer than women who had not used IUC. The study has received media attention and the FSRH CEU considered it important to put the findings into perspective.

Key findings

• The odds ratio (OR) association between any use compared to never use of IUC and cervical cancer was 0.64 (95% CI, 0.53-0.77), suggesting that the risk of developing cervical cancer was 36% lower in women who had ever used IUC.
• This meta-analysis does not establish a causal association between use of IUC and reduced risk of cervical cancer. 

These data come from time periods and settings without HPV vaccination and with variable cervical screening and cervical cancer burden. Therefore, even if there is a protective effect, it is unknown whether this finding would be applicable in the UK setting where HPV vaccination and cervical screening are standard. Further evidence, and consideration of the mechanism by which IUC use could protect against cervical cancer, are needed before conclusions are drawn about this potential non-contraceptive benefit of IUC.

Implications for clinical practice

• This meta-analysis does not alter existing FSRH guidance. The FSRH guideline Intrauterine Contraception recommends that copper intrauterine (CU-IUD) use may be associated with a reduced risk of cervical cancer.4 
• Available data do not support recommending IUC for the purpose of cervical cancer prevention.
• Clinicians should advise all women that HPV vaccination, condom use and regular cervical screening remain the most effective ways to reduce cervical cancer risk.

Read the statement in full at the link below.