IUDs, Lower Cervical Cancer Rates and HPV – Is There a Connection?
Previous studies have demonstrated a decrease in cervical cancer associated with use of intrauterine devices (IUDs). This study by Averbach et al. (AJOG, 2017) sought to explore whether IUDs may impact cervical high-risk HPV infection as a possible mechanism for this protective association.
Prospective Cohort Study
676 sexually active young women were surveyed, 85 of whom had IUDs. Women reported IUD use at 505 out of 14,513 visits. Following adjustment for possible cofounders, no association between IUD use and HPV acquisition was found (hazard ratio, 0.50; 95% CI, 0.20-1.23; P = .13). Nor was there an association between IUD use and clearance of HPV (hazard ratio, 1.44; 95% CI, 0.76-2.72; P = .26). This study confirms that IUD use is safe in women with HPV or at risk for HPV. In addition, any protective effect of IUDs with respect to cervical cancer does not appear to be related to impact upon HPV infection. The authors surmise that perhaps IUDs in some way inhibit precancerous lesion development in women with HPV and/or enhance clearance of the HPV virus.
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