Systematic review and meta-analysis on the impact of the levonorgestrel-releasing intrauterine system in reducing risk of ovarian cancer

Background Ovarian carcinoma (OC) is one of the most widespread tumors in the world and is characterized by low survival rates. Objective To determine whether the levonorgestrel-releasing intrauterine system (LNG-IUS) can prevent OC. Search strategy The literature until December 2020 were systematically reviewed according to the PRISMA Statement for Reporting Systematic Reviews (PROSPERO: CRD42019137957). Selection criteria Studies assessing the impact of LNG-IUS on the risk of OC were included. Data collection and analysis Data were extracted independently by two authors to ensure accuracy and consistency. Main results A total of 34 323 records were obtained, of which three satisfied the inclusion criteria. In total, 1687 events of OC in a population of 20 461 311 person-years were considered. Data pooling revealed that the use of LNG-IUS did not confer a lower risk of OC relative to the never-use of LNG-IUS, with an estimated odds ratio of 0.66 (95% confidence interval 0.41-1.08; I-2 = 84%; P = 0.002). Conclusion The meta-analysis did not demonstrate a preventive role of LNG-IUS on OC. However, it was carried out on a few papers, and a definitive conclusion on the topic still cannot be drawn. Further studies are indicated in the future to define the impact of LNG-IUS on OC. The meta-analysis carried out on three papers did not demonstrate a preventive role of the levonorgestrel-releasing intrauterine device on ovarian cancer.