Systematic review and meta-analysis on the impact of the levonorgestrel-releasing intrauterine system in reducing risk of ovarian cancer

Abstract

Background: Ovarian carcinoma (OC) is one of the most widespread tumors in the world and is characterized by low survival rates.

Objective: To determine whether the levonorgestrel-releasing intrauterine system (LNG-IUS) can prevent OC.

Search strategy: The literature until December 2020 were systematically reviewed according to the PRISMA Statement for Reporting Systematic Reviews (PROSPERO: CRD42019137957).

Selection criteria: Studies assessing the impact of LNG-IUS on the risk of OC were included.

Data collection and analysis: Data were extracted independently by two authors to ensure accuracy and consistency.

Main results: A total of 34 323 records were obtained, of which three satisfied the inclusion criteria. In total, 1687 events of OC in a population of 20 461 311 person-years were considered. Data pooling revealed that the use of LNG-IUS did not confer a lower risk of OC relative to the never-use of LNG-IUS, with an estimated odds ratio of 0.66 (95% confidence interval 0.41-1.08; I² = 84%; P = 0.002).

Conclusion: The meta-analysis did not demonstrate a preventive role of LNG-IUS on OC. However, it was carried out on a few papers, and a definitive conclusion on the topic still cannot be drawn. Further studies are indicated in the future to define the impact of LNG-IUS on OC. The meta-analysis carried out on three papers did not demonstrate a preventive role of the levonorgestrel-releasing intrauterine device on ovarian cancer.

Keywords: contraceptives cancer risk; intrauterine device; levonorgestrel-releasing intrauterine system; ovarian cancer; risk factors for ovarian carcinoma.