Abstract
Depot-medroxyprogesterone acetate (DMPA) is a long-acting progestational contraceptive, which is administered by injection. It was developed in the mid-1960s, when it was seen as a method that would be particularly useful for women seeking reversible contraception who had difficulty taking a pill every day. DMPA has been shown to be a highly effective contraceptive, and it has proved acceptable in a variety of settings. The drug is licensed as a contraceptive in more than 90 countries and has been widely used in a number of them, such as Thailand and New Zealand. On a worldwide basis, the licensing, acceptability, and prevalence of use have been influenced by concern that DMPA may increase the risk of cancer. Cancer of the breast has been a particular concern. This Memorandum reviews comprehensively the results of toxicological tests in animals and epidemiological studies in humans concerning the carcinogenicity of DMPA.
Full text
PDF







Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Braunsberg H. A., Coldham N. G., Wong W. Hormonal therapies for breast cancer: can progestogens stimulate growth? Cancer Lett. 1986 Feb;30(2):213–218. doi: 10.1016/0304-3835(86)90091-1. [DOI] [PubMed] [Google Scholar]
- Concannon P. W., Spraker T. R., Casey H. W., Hansel W. Gross and histopathologic effects of medroxyprogesterone acetate and progesterone on the mammary glands of adult beagle bitches. Fertil Steril. 1981 Sep;36(3):373–387. [PubMed] [Google Scholar]
- Dabancens A., Prado R., Larraguibel R., Zañartu J. Intraepithelial cervical neoplasia in women using intrauterine devices and long-acting injectable progestogens as contraceptives. Am J Obstet Gynecol. 1974 Aug 15;119(8):1052–1056. doi: 10.1016/0002-9378(74)90257-9. [DOI] [PubMed] [Google Scholar]
- Dauvois S., Spinola P. G., Labrie F. Additive inhibitory effects of bromocryptine (CB-154) and medroxyprogesterone acetate (MPA) on dimethylbenz[a]anthracene (DMBA)-induced mammary tumors in the rat. Eur J Cancer Clin Oncol. 1989 May;25(5):891–897. doi: 10.1016/0277-5379(89)90137-5. [DOI] [PubMed] [Google Scholar]
- Garcia Heras J., Coco R. Induction of sister chromatid exchanges in rabbit lymphocytes by medroxyprogesterone. Medicina (B Aires) 1982;42(3):250–254. [PubMed] [Google Scholar]
- Greenspan A. R., Hatcher R. A., Moore M., Rosenberg M. J., Ory H. W. The association of depo-medroxyprogesterone acetate and breast cancer. Contraception. 1980 Jun;21(6):563–569. doi: 10.1016/0010-7824(80)90029-3. [DOI] [PubMed] [Google Scholar]
- Hussain S. P., Rao A. R. Modulatory influence of injectable contraceptive steroid medroxyprogesterone acetate on methylcholanthrene-induced carcinogenesis in the uterine cervix of mouse. Cancer Lett. 1992 Jan 31;61(3):187–193. doi: 10.1016/0304-3835(92)90286-5. [DOI] [PubMed] [Google Scholar]
- Jordan A. FDA requirements for nonclinical testing of contraceptive steroids. Contraception. 1992 Dec;46(6):499–509. doi: 10.1016/0010-7824(92)90114-9. [DOI] [PubMed] [Google Scholar]
- Lanari C., Molinolo A. A., Pasqualini C. D. Induction of mammary adenocarcinomas by medroxyprogesterone acetate in BALB/c female mice. Cancer Lett. 1986 Nov;33(2):215–223. doi: 10.1016/0304-3835(86)90027-3. [DOI] [PubMed] [Google Scholar]
- Liang A. P., Levenson A. G., Layde P. M., Shelton J. D., Hatcher R. A., Potts M., Michelson M. J. Risk of breast, uterine corpus, and ovarian cancer in women receiving medroxyprogesterone injections. JAMA. 1983 Jun 3;249(21):2909–2912. [PubMed] [Google Scholar]
- Nagasawa H., Aoki M., Sakagami N., Ishida M. Medroxyprogesterone acetate enhances spontaneous mammary tumorigenesis and uterine adenomyosis in mice. Breast Cancer Res Treat. 1988 Sep;12(1):59–66. doi: 10.1007/BF01805741. [DOI] [PubMed] [Google Scholar]
- Oberle M. W., Rosero-Bixby L., Irwin K. L., Fortney J. A., Lee N. C., Whatley A. S., Bonhomme M. G. Cervical cancer risk and use of depot-medroxyprogesterone acetate in Costa Rica. Int J Epidemiol. 1988 Dec;17(4):718–723. doi: 10.1093/ije/17.4.718. [DOI] [PubMed] [Google Scholar]
- Paul C., Skegg D. C., Spears G. F. Depot medroxyprogesterone (Depo-Provera) and risk of breast cancer. BMJ. 1989 Sep 23;299(6702):759–762. doi: 10.1136/bmj.299.6702.759. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pazos P., Lanari C., Meiss R., Charreau E. H., Pasqualini C. D. Mammary carcinogenesis induced by N-methyl-N-nitrosourea (MNU) and medroxyprogesterone acetate (MPA) in BALB/c mice. Breast Cancer Res Treat. 1992 Jan;20(2):133–138. doi: 10.1007/BF01834643. [DOI] [PubMed] [Google Scholar]
- Powell L. C., Jr, Seymour R. J. Effects of depo-medroxyprogesterone acetate as a contraceptive agent. Am J Obstet Gynecol. 1971 May 1;110(1):36–41. doi: 10.1016/0002-9378(71)90210-9. [DOI] [PubMed] [Google Scholar]
- Russo I. H., Gimotty P., Dupuis M., Russo J. Effect of medroxyprogesterone acetate on the response of the rat mammary gland to carcinogenesis. Br J Cancer. 1989 Feb;59(2):210–216. doi: 10.1038/bjc.1989.43. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schlesselman J. J. Oral contraceptives and neoplasia of the uterine corpus. Contraception. 1991 Jun;43(6):557–579. doi: 10.1016/0010-7824(91)90004-y. [DOI] [PubMed] [Google Scholar]
- Spellacy W. N., Mcleod A. G., Buhi W. C., Birk S. A. The effects of medroxyprogesterone acetate on carbohydrate metabolism: measurements of glucose, insulin, and growth hormone after twelve months' use. Fertil Steril. 1972 Apr;23(4):239–244. [PubMed] [Google Scholar]
- Stanford J. L. Oral contraceptives and neoplasia of the ovary. Contraception. 1991 Jun;43(6):543–556. doi: 10.1016/0010-7824(91)90003-x. [DOI] [PubMed] [Google Scholar]
- Williams D. L., Hagen A. A., Runyan J. W. Chromosome alterations produced in germ cells of dogs by progesterone. J Lab Clin Med. 1971 Mar;77(3):417–429. [PubMed] [Google Scholar]
- Williams D. L., Runyan J. W., Jr, Hagen A. A. Progesterone-induced alterations of oogenesis in the Chinese hamster. J Lab Clin Med. 1972 Jun;79(6):972–977. [PubMed] [Google Scholar]
- Zaccheo T., Casazza A. M., di Salle E., Pollini C., di Marco A. Combined and sequential treatment using FCE 21336, a new prolactin-lowering drug, and medroxyprogesterone acetate (MPA) in DMBA-induced tumors in rats. Eur J Cancer Clin Oncol. 1984 Sep;20(9):1193–1197. doi: 10.1016/0277-5379(84)90129-9. [DOI] [PubMed] [Google Scholar]
