title: Meta-analysis of intrauterine device use and risk of endometrial cancer.
abstract: OBJECTIVE
  We sought to study the association between intrauterine device (IUD) use and endometrial cancer.
  
  
  METHODS
  A comprehensive search of literature published through April 2007 was conducted, studies reviewed, and data abstracted. Data from ten studies were pooled and analyzed using both fixed- and random-effects models to examine the association of ever use of an IUD and endometrial cancer.
  
  
  RESULTS
  Based on the random effects model, a protective crude association between IUD use and endometrial cancer was observed (odds ratio [OR] = 0.39; 95% confidence interval [CI] = 0.29-0.51; heterogeneity p < 0.001) with a pooled adjusted risk of OR = 0.54 (95% CI, 0.47-0.63; heterogeneity p = 0.40). A decreased risk of endometrial cancer also was seen for increased years of IUD use (OR for 5 years of use 0.88; 95% CI = 0.84-0.92; n = 5; heterogeneity p = 0.14), increased years since last IUD use (OR for 5 years of use 0.91; 95% CI, 0.86-0.95; n = 4; heterogeneity p = 0.02), and increased years since first IUD use (OR for 5 years of use 0.89; 95% CI, 0.83-0.95; n = 4; heterogeneity p = 0.04).
  
  
  CONCLUSIONS
  Our results suggest that nonhormonal IUD use may be associated with a decreased risk for endometrial cancer; however, the exact mechanism for this association is unclear. Future investigations should address the difference in the proposed association by specific type of IUDs.
authors.affiliation: Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA.
authors.forename: Robin M
authors.initials: RM
authors.lastname: Beining
authors.forename: Leslie K
authors.initials: LK
authors.lastname: Dennis
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Smith
authors.forename: Anuja
authors.initials: A
authors.lastname: Dokras
mesh_terms: D000328:Adult; D000368:Aged; D016889:Endometrial Neoplasms / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data*; D008875:Middle Aged; D012307:Risk Factors