{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T23:59:15Z","timestamp":1788998355550,"version":"build-2803163510"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:00:00Z","timestamp":1736812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Australian National Health and Medical Research Council","award":["GNT1121151"],"award-info":[{"award-number":["GNT1121151"]}]},{"name":"Australian National Health and Medical Research Council","award":["GNT1173346"],"award-info":[{"award-number":["GNT1173346"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Use of long-acting, reversible contraceptives has increased over the past 20\u2009years, but an understanding of how they could influence cancer risk is limited.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a nested case-control study among a national cohort of Australian women (n\u2009=\u2009176\u00a0601 diagnosed with cancer between 2004 and 2013; 882\u00a0999 matched control individuals) to investigate the associations between the levonorgestrel intrauterine system, etonogestrel implants, depot-medroxyprogesterone acetate and cancer risk and compared these results with the oral contraceptive pill. We used conditional logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Levonorgestrel intrauterine system and etonogestrel implant use was associated with breast cancer risk (OR\u2009=\u20091.26, 95% CI\u2009=\u20091.21 to 1.31, and OR\u2009=\u20091.24, 95% CI\u2009=\u20091.17 to 1.32, respectively), but depot-medroxyprogesterone acetate was not, except when used for 5 or more years (OR\u2009=\u20091.23, 95% CI\u2009=\u20090.95 to 1.59). Reduced risks were seen for levonorgestrel intrauterine system (\u22651 years of use) in endometrial cancer (OR\u2009=\u20090.80, 95% CI\u2009=\u20090.65 to 0.99), ovarian cancer (OR\u2009=\u20090.71, 95% CI\u2009=\u20090.57 to 0.88), and cervical cancer (OR\u2009=\u20090.62, 95% CI\u2009=\u20090.51 to 0.75); for etonogestrel implant in endometrial cancer (OR\u2009=\u20090.21, 95% CI\u2009=\u20090.13 to 0.34) and ovarian cancer (OR\u2009=\u20090.76, 95% CI\u2009=\u20090.57 to 1.02); and for depot-medroxyprogesterone acetate in endometrial cancer (OR\u2009=\u20090.21, 95% CI\u2009=\u20090.13 to 0.34). Although levonorgestrel intrauterine system, etonogestrel implant and depot-medroxyprogesterone acetate were all associated with increased cancer risk overall, for etonogestrel implant, the risk returned to baseline after cessation, similar to the oral contraceptive pill. We were unable to adjust for all potential confounders, but sensitivity analyses suggested that adjusting for parity, smoking, and obesity would not have materially changed our findings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Long-acting, reversible contraceptives have similar cancer associations to the oral contraceptive pill (reduced endometrial and ovarian cancer risks and short-term increased breast cancer risk). This information may be helpful to women and their physicians when discussing contraception options.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jnci\/djae282","type":"journal-article","created":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:02:01Z","timestamp":1736812921000},"page":"1046-1055","source":"Crossref","is-referenced-by-count":15,"title":["Long-acting, progestin-based contraceptives and risk of breast, gynecological, and other cancers"],"prefix":"10.1093","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5944-5085","authenticated-orcid":false,"given":"Karen M","family":"Tuesley","sequence":"first","affiliation":[{"name":"School of Public Health, University of Queensland , Brisbane, QLD 4006,","place":["Australia"]},{"name":"Population Health Program, QIMR Berghofer Medical Research Institute , Brisbane, QLD 4006,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7434-2957","authenticated-orcid":false,"given":"Katrina","family":"Spilsbury","sequence":"additional","affiliation":[{"name":"Institute for Health Research, The University of Notre Dame Australia , Fremantle, WA 6160,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7137-6855","authenticated-orcid":false,"given":"Sallie-Anne","family":"Pearson","sequence":"additional","affiliation":[{"name":"School of Population Health, University of New South Wales , Sydney, NSW 2052,","place":["Australia"]},{"name":"Centre of Research Excellence in Medicines Intelligence, University of New South Wales , Sydney, NSW 2052,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7934-601X","authenticated-orcid":false,"given":"Peter","family":"Donovan","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Department, Royal Brisbane and Women\u2019s Hospital , Brisbane, QLD 4006,","place":["Australia"]},{"name":"Faculty of Medicine, University of Queensland , Brisbane, QLD 4006,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2199-1117","authenticated-orcid":false,"given":"Andreas","family":"Obermair","sequence":"additional","affiliation":[{"name":"Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women\u2019s Hospital , Brisbane, QLD 4006,","place":["Australia"]},{"name":"Centre for Clinical Research, University of Queensland , Brisbane, QLD 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4006,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1462-4968","authenticated-orcid":false,"given":"Nirmala","family":"Pandeya","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Queensland , Brisbane, QLD 4006,","place":["Australia"]},{"name":"Population Health Program, QIMR Berghofer Medical Research Institute , Brisbane, QLD 4006,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2015-6320","authenticated-orcid":false,"given":"Louise","family":"Stewart","sequence":"additional","affiliation":[{"name":"School of Population and Global Health, The University of Western Australia , Perth, WA 6009,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4566-1414","authenticated-orcid":false,"given":"Susan 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