Copper IUD Use Associated with Decreased Cervical Cancer Risk Compared Hormonal Intrauterine System

Women who use copper intrauterine devices (IUDs) as a form of birth control may be at lower risk for high-grade cervical cancer compared with those who use a levonorgestrel-releasing intrauterine system (LNG-IUS), according to study findings recently published in Obstetrics & Gynecology.

The lower incidence of high-grade cervical cancer in the copper IUD cohort is consistent with data that were previously reported in 2000 from an LNG-IUS U.S. Food and Drug Administration application, the researchers wrote.

“Copper and hormonal IUDs may have different physiological effects on the female genitourinary system,” lead study author Dr. Matthew Spotnitz, a postdoctoral research scientist at Columbia University Irving Medical Center, said in a press release. “Consequently, the risk of cervical neoplasms may be different for copper and hormonal IUD users.”

The researchers performed a retrospective cohort analysis of 10,674 patients who received IUDs at Columbia University Medical Center to assess the relative risk of cervical cancer among people who use copper IUD and LNG-IUS.

The data was a part of the Observational Health Data Sciences and Informatics (OHDSI) network, which is an open-science collaborative of more than 220 health care organizations across the world.

Patients were continuously observed within the database for at least one year prior to the IUD being inserted. Women who were 45 years old or younger at the time of IUD placement were included in the cohort. The researchers excluded women who had a history of endometrial or cervical cancer, or who had a prior IUD placement.

A high-grade cervical cancer diagnosis served as the study’s primary outcome.

Of the total number of patients from the cohort, 8,274 had received a copper IUD and 2,400 had received an LNG-IUS. During follow up, 22% of the people who received a copper IUD and 33.2% of those who received an LNG-IUS had a documented procedure to remove their IUD.

A total of 114 people within the study population received a cervical cancer diagnosis, of which 77 women in the copper IUD cohort and 37 women in the LNG-IUS cohort developed high-grade cervical cancer.

“Our findings may help patients and health care providers make informed decisions about whether the benefits of hormonal IUD use, compared to copper IUD use, are greater than the risks,” Spotnitz said.

The research team, according to Spotnitz, hopes to lead a study across other databases within the OHDSI network, which spans 19 countries and includes more than one billion patient records.

“The proportions of women who use copper and hormonal IUDs may vary among institutions,” Spotnitz said. “Overall, IUD use has become more popular over the past 20 years. Copper IUD use has remained constant whereas hormonal IUD use has increased. The rising popularity of hormonal IUDs may be related to the fact that they decrease the pain and bleeding of menses.”