Contraceptive coil may help prevent cancer of womb

NEW research will aim to discover whether a form of contraceptive coil can stop women developing womb cancer.

A study being carried out by St George’s, University of London is examining whether the Mirena IUS device can cut the rate of endometrial cancer, or cancer of the womb lining, among high-risk patients. The IUS (intrauterine system device) is inserted into the womb and releases progestogen, blocking the entry of sperm by thickening the mucus made by the cervix until it forms a ‘plug’.

It also reduces the thickness of the womb walls, which scientists believe could be the key to reducing rates of endometrial cancer among patients with cancer-predisposing syndrome HNPCC (hereditary colon cancer syndrome), which is hereditary, or Lynch syndrome.

Endometrial cancer is the fifth most common cancer in women in the UK, with most cases being diagnosed after the menopause. While two per cent of British women will develop it, among those with HNPCC the rate rises to 60 per cent.

In a pilot study, 15 women had the Mirena brand of IUS fitted by Tom Bourne’s team, with early results described as ‘promising’. Now scientists are recruiting 220 high-risk patients to carry out a four-year, UK-wide trial.

Each patient will undergo a baseline examination, ultrasound and biopsy. If these results are normal then individuals will be randomly divided into a group fitted with the Mirena IUS and a control group.

Annual ultrasound and pipelle biopsies will be carried out on all patients to check for any signs of cancer and a questionnaire used to analyse the psychological effects of the trial.

Professor Shirley Hodgson, Professor of Cancer Genetics at St George’s, University of London, said: ‘We are uncertain of the efficacy of screening for endometrial cancer in women at increased risk of this cancer, so prevention is the key.’

She added: ‘There is some evidence that the Mirena IUS reduces the risk of endometrial cancer in all women, and we hope that this study can show that it has this effect in this important group of women at high risk, who otherwise might opt for hysterectomy.’

The research is being carried out in collaboration with Queen Mary, University of London, with St George’s Hospital, with funding from Cancer Research UK.