title: Depot medroxyprogesterone acetate and epithelial ovarian cancer: a multicentre case-control study.
abstract: OBJECTIVE
  To evaluate the effect of depot medroxyprogesterone acetate (DMPA) in protecting against epithelial ovarian cancer (EOC) and to evaluate factors associated with the risk of EOC.
  
  
  METHODS
  A multicentre, case-control study.
  
  
  METHODS
  Twelve hospitals located across Thailand.
  
  
  METHODS
  Three hundred and thirty patients with EOC ('cases') and 982 matched controls were recruited from the 12 hospitals. Cases were newly diagnosed patients with EOC, demonstrated pathologically. Controls were age-matched patients admitted to different wards in the same hospital.
  
  
  METHODS
  Cases and controls were interviewed by trained interviewers using a standardised pre-tested questionnaire. The factors associated with EOC were evaluated using univariate and multivariate analyses.
  
  
  METHODS
  The odds ratio (OR) and 95% confidence interval (95% CI) were calculated to assess the relationship between DMPA and EOC.
  
  
  RESULTS
  The use of DMPA was found to be associated with a 39% reduction in the risk of EOC with an OR of 0.61 and a 95% CI of 0.44-0.85 (P = 0.002). A significant risk reduction (83%) was observed when the duration of DMPA use was >3 years (OR 0.17; 95% CI 0.07-0.39; P < 0.001). Other factors associated with a reduced risk of EOC were the use of combined oral contraceptive pills and breastfeeding. A factor associated with an increased risk of EOC was a family history of gynaecological cancer.
  
  
  CONCLUSIONS
  The results suggest that DMPA may have a protective effect against EOC. If this effect is real, then it represents an important non-contraceptive benefit of DMPA.
authors.affiliation: Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. raswl@mahidol.ac.th
authors.forename: S
authors.initials: S
authors.lastname: Wilailak
authors.forename: C
authors.initials: C
authors.lastname: Vipupinyo
authors.forename: V
authors.initials: V
authors.lastname: Suraseranivong
authors.forename: K
authors.initials: K
authors.lastname: Chotivanich
authors.forename: C
authors.initials: C
authors.lastname: Kietpeerakool
authors.forename: Y
authors.initials: Y
authors.lastname: Tanapat
authors.forename: S
authors.initials: S
authors.lastname: Therasakvichya
authors.forename: S
authors.initials: S
authors.lastname: Hamontri
authors.forename: V
authors.initials: V
authors.lastname: Linasmita
authors.forename: S
authors.initials: S
authors.lastname: Bunyapipat
authors.forename: S
authors.initials: S
authors.lastname: Chindavijak
authors.forename: K
authors.initials: K
authors.lastname: Ittiwisavakul
authors.forename: N
authors.initials: N
authors.lastname: Khemapech
authors.forename: P
authors.initials: P
authors.lastname: Suekwattana
authors.forename: D
authors.initials: D
authors.lastname: Thanapprapasr
authors.forename: P
authors.initials: P
authors.lastname: Lumbiganon
mesh_terms: D000077216:Carcinoma, Ovarian Epithelial; D016022:Case-Control Studies; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology* / Q000517:prevention & control; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors; D057566:Self Report; D013785:Thailand / Q000453:epidemiology
chemical_list: D003271:Contraceptive Agents, Female; D017258:Medroxyprogesterone Acetate