Is there a Relationship between Combined Oral Contraceptive Use and Intrauterine Device Use with Abnormal Smear Results and Cervical Atypia?Correspondence Address :
Dr. Selçuk Kaplan,
AltinsÂ¸ ehir Mahallesi Ikidam Cad. Zümrüt Gold City 5 kat: 4 No:7, Adiyaman,
Introduction: The relationship between the use of contraceptive method and the presence of Human Papilloma Virus (HPV) persistent infection and precancerous cervical lesions has not been fully established.
Aim: To investigate the frequency of cervical atypia and risk factors affecting it in women using Combined Oral Contraceptive (COC) and Copper-Intrauterine Device Use (Cu-IUD).
Materials and Methods: A retrospective study was conducted in a tertiary centre between 2017 to 2019, involving 835 patients using Cu-IUD and 538 patients using COC. Age, obstetric data, high-risk HPV type positivity, education level, location, occupation, Body Mass Index (BMI), smoking, cervical cytology results and colposcopic biopsy results were noted for each group. Statistical Package for the Social Sciences (SPSS) version 22.0 program was used to analyse the data. Pearson chi-square test and multivariate binary logistic regression test were performed. Model compatibility was good in binary logistics test (omnibus test p<0.001). The p<0.05 value was considered statistically significant.
Results: The frequency of CIN I lesions increased in women using Cu-IUD (p=0.038), while the frequency of CIN II+ lesions increased in COC users. The use of COC increased the risk of CIN II+ (p=0.014). High-risk HPV type positivity was common in those using COC (p<0.05). In addition, 40-51-year-old, education level being primary, being multiparous, urban location, high risk HPV positivity are risk factors for the presence of cervical atypia (p<0.05).
Conclusion: The risk of CIN I increased in those using Cu-IUD, while the risk of CIN II+ increased in those using COC.
Contraception, Copper intrauterine devices, Human papillomavirus, Oral, Pap smear
Date of Submission: Apr 09, 2020
Date of Peer Review: May 15, 2020
Date of Acceptance: Jun 23, 2020
Date of Publishing: Sep 01, 2020
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
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ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)