ABSTRACT
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.
Subject(s)
Contraceptive Agents, Female , Endometrial Neoplasms , Humans , Female , Child, Preschool , Male , Medroxyprogesterone Acetate/adverse effects , Case-Control Studies , Endometrial Neoplasms/chemically induced , Endometrial Neoplasms/epidemiology , Contraceptive Agents, Female/adverse effects , Endometrium , Delayed-Action PreparationsABSTRACT
OBJECTIVE: To assess pregnancy intention and the associated risks among young pregnant women. METHODS: In a descriptive study, pregnant women aged 15-24 years were recruited at a prenatal clinic in Chiang Mai University Hospital, Thailand, between March 1, 2012, and February 28, 2013. Participants were interviewed by trained interviewers using a standardized questionnaire to elicit information about baseline characteristics, pregnancy intention, and contraception practice. RESULTS: Overall, 250 participants were recruited (mean age 20.7±2.4 years), and 163 (65.2%) declared that the pregnancy was unintended. The odds of the pregnancy being unintended were increased in students (P=0.006), women aged 20 years or younger (P=0.024), and women whose partner was a similar age (P=0.026). A higher percentage of women with unintended pregnancy than with intended pregnancy reported having no time to use contraception, a perceived difficulty of regular contraceptive use, fear of parents finding out about sexual activity, and embarrassment about using contraception. CONCLUSION: Pregnancy among young pregnant women in Thailand was often unintended. Educational status, age, and age difference between the couple were independently associated with unintended pregnancy.
