Depot medroxyprogesterone acetate and endometrial cancer: A multicenter case-control study.

OBJECTIVE: To assess the associations between depot medroxyprogesterone acetate (DMPA) and endometrial cancer. METHODS: This multicenter case-control study was conducted among tertiary hospitals in Thailand. Patients were women with endometrial cancer. Controls were women admitted for other conditions, matched for age within 5 years of the patients' age. The controls had to have no abnormal vaginal bleeding, history of hysterectomy, or cancers of the other organs. A standardized questionnaire was used to gather information. Conditional logistic regression was applied to calculate adjusted odds ratio (aORs) and 95% confidence intervals (CIs). RESULTS: During 2015 to 2021, 378 patients and 1134 controls were included. Ever use of DMPA was associated with a 70% decreased overall risk of endometrial cancer (aOR, 0.30 [95% CI, 0.21-0.42]). Endometrial cancer risk declined by 3% (aOR, 0.97 [95% CI, 0.96-0.98]) for every 3 months of DMPA use. The magnitude of the decline in endometrial cancer risk did not vary appreciably by cancer subtypes (aOR, 0.26 [95% CI, 0.17-0.41] and 0.38 [95% CI, 0.22-0.65] for low-grade and high-grade tumors, respectively). CONCLUSIONS: Depot medroxyprogesterone acetate use was inversely associated with endometrial cancer risk in a duration-dependent manner. This association was independent of cancer subtype.

Factors affecting compliance in the first year of postcolposcopy surveillance among women with a high incidence of cervical cancer.

OBJECTIVE: To assess postcolposcopy compliance among women with abnormal cervical screening results and to identify factors associated with noncompliance for postcolposcopy follow-up. METHODS: In a retrospective study, the records of women who underwent colposcopy at Srinagarind Hospital, Thailand, between January and December 2010 were reviewed. Women were considered to be noncompliant if their total follow-up time after colposcopy was less than 12months. Univariate and multivariate logistic regression methods were used to determine factors significantly predicting noncompliance. RESULTS: Among 548 women who underwent colposcopy, the percentage of noncompliance was 49.5% (95% confidence interval [CI], 45.1%-53.7%). The risk for noncompliance rose significantly among those without intraepithelial lesions (OR, 2.19; 95% CI, 1.53-3.13), younger age (OR, 1.79; 95% CI, 1.19-2.67), and low education level (OR, 1.58; 95% CI, 1.11-2.24). Risk for noncompliance was significantly lower among those with a previous history of abnormal smear (OR, 0.39; 95% CI, 0.24-0.64). CONCLUSION: The percentage of noncompliance with postcolposcopy follow-up was high among the study women. The significant independent factors predicting noncompliance were previous history of abnormal smear, severity of cervical histopathology, age, and education level.