Table 1 Summary of select studies investigating the relationship between use of a long-acting reversible contraceptive (intrauterine device, injection or implant) and ovarian cancer risk in the general population

Tworoger, 2007 [48]

USA

Cohort

Overall (n = 107,900)

Cases (n = 625)

Exposed (64,847 p-years)

Any IUD

Ever use

All

1.76 (1.08–2.85)

Age, age at menarche, age at menopause, BMI, oral contraceptive use, parity, postmenopausal hormone use, tubal ligation, smoking

Wilailak, 2012 [49]

Thailand

Case-control

Cases (n = 330)

Controls (n = 982)

DMPA

Ever use

All

0.61 (0.44–0.85)

Oral contraceptive use, breastfeeding, parity, family history of gynecological cancer

Urban, 2012 [50]

South Africa

Case-control

Cases (n = 182)

Controls (n = 1492)

Any injectable

Ever use

All

0.69 (0.36–1.32)

Age at diagnosis, year of diagnosis, education, tobacco smoking, alcohol consumption, parity/age at first birth, number of sexual partners, urban/rural residence, province of birth

Huang, 2015 [51]

China

Cohort

Overall (n = 70,529)

Cases (n = 174)

Exposed (n = 39,054)

Any IUD

Ever use

All

0.79 (0.55–1.13)

Age, education, years of ovulation, irregular ovulatory cycles, first-degree family history of cancer, BMI, physical activity, other contraceptive methods

Any injectable

Ever use

All

1.33 (0.58–3.04)

Soini, 2016 [54]

Finland

Cohort

Overall (n = 93,843)

Cases (n = 77)

LNG IUD

Ever use

All

0.59 (0.47–0.73)

n/a

Jareid, 2018 [53]

Norway

Cohort

Overall (n = 104,318)

Exposed (n = 9146)

LNG IUD

Ever use

All

0.53 (0.32–0.88)

Age, parity, BMI, oral contraceptive use, menopausal status, maternal history of breast cancer, physical activity

Iversen, 2018 [45]

Denmark

Cohort

Overall (n = 104,318; 21.4 million p-years)

IUD (172,265 p-years)

DMPA (7321 p-years)

Implant (58,371 p-years)

LNG IUD

Curent or recent exclusive use

All

0.84 (0.53–1.35)

Calendar year, parity, age, education, tubal sterilisation, hysterectomy, endometriosis, polycystic ovary syndrome, family history of breast or ovarian cancer

DMPA

Current or recent exclusive use

All

6.56 (2.11–20.40)

Any implant

Current or recent use

All

0.51 (0.07–3.64)

Wheeler, 2019 [52]

International

Meta-analysis

9 case-control studies

2 cohort studies

Cases (n = 5133)

Controls (n = 183,035)

Any IUD

Ever use

All

0.68 (0.62–0.75)

n/a

Balayla, 2020 [46]

International

Meta-analysis

5 case-control studies

2 cohort studies

Any IUD

LNG IUD

Ever use

All

0.67 (0.60–0.74)

0.58 (0.47–0.71)

n/a

Yang, 2021 [47]

USA

Pooled analysis

NECC, NHSI, NHSII

Any IUD

Ever use

All

0.96 (0.81–1.14)

Age, body mass index, age at menarche, parity, oral contraceptive use, history of tubal ligation, family history of ovarian cancer, study center, study phase (NECC)

Phung, 2021 [44]

Australia

Pooled analysis

7 case-control studies

Cases (n = 5064)

DMPA

Ever use

All

0.65 (0.50–0.85)

Race/ethnicity, age, education level, oral contraceptive use duration, Parity, breastfeeding