Depot medroxyprogesterone acetate and epithelial ovarian cancer: a multicentre case-control study

BJOG. 2012 May;119(6):672-7. doi: 10.1111/j.1471-0528.2012.03298.x.


Objective: To evaluate the effect of depot medroxyprogesterone acetate (DMPA) in protecting against epithelial ovarian cancer (EOC) and to evaluate factors associated with the risk of EOC.

Design: A multicentre, case-control study.

Setting: Twelve hospitals located across Thailand.

Population: Three hundred and thirty patients with EOC ('cases') and 982 matched controls were recruited from the 12 hospitals. Cases were newly diagnosed patients with EOC, demonstrated pathologically. Controls were age-matched patients admitted to different wards in the same hospital.

Methods: Cases and controls were interviewed by trained interviewers using a standardised pre-tested questionnaire. The factors associated with EOC were evaluated using univariate and multivariate analyses.

Main outcome measures: The odds ratio (OR) and 95% confidence interval (95% CI) were calculated to assess the relationship between DMPA and EOC.

Results: The use of DMPA was found to be associated with a 39% reduction in the risk of EOC with an OR of 0.61 and a 95% CI of 0.44-0.85 (P = 0.002). A significant risk reduction (83%) was observed when the duration of DMPA use was >3 years (OR 0.17; 95% CI 0.07-0.39; P < 0.001). Other factors associated with a reduced risk of EOC were the use of combined oral contraceptive pills and breastfeeding. A factor associated with an increased risk of EOC was a family history of gynaecological cancer.

Conclusions: The results suggest that DMPA may have a protective effect against EOC. If this effect is real, then it represents an important non-contraceptive benefit of DMPA.

Publication types

  • Multicenter Study

MeSH terms

  • Carcinoma, Ovarian Epithelial
  • Case-Control Studies
  • Contraceptive Agents, Female / administration & dosage*
  • Female
  • Humans
  • Medroxyprogesterone Acetate / administration & dosage*
  • Middle Aged
  • Neoplasms, Glandular and Epithelial / epidemiology*
  • Neoplasms, Glandular and Epithelial / prevention & control
  • Ovarian Neoplasms / epidemiology*
  • Ovarian Neoplasms / prevention & control
  • Risk Factors
  • Self Report
  • Thailand / epidemiology


  • Contraceptive Agents, Female
  • Medroxyprogesterone Acetate