Differences in cervical cytologic and histologic findings between women using depot-medroxyprogesterone acetate and oral contraceptives
Journal of lower genital tract disease
NLM Title Abbreviation
J Low Genit Tract Dis
OBJECTIVE: This study aimed to compare cervical cytologic and histologic findings between women using depot-medroxyprogesterone acetate (DMPA) and oral contraceptives (OCs) referred for colposcopy and to determine whether there were differences in the occurrence of false-positive cytologic finding between the 2 contraceptive groups. MATERIALS AND METHODS: Retrospective cohort of 1,569 premenopausal women using either DMPA or OC who were evaluated for abnormal cervical cytologic findings. Cytologic and histologic data were collected in conjunction with routine gynecologic examinations or follow-up colposcopic evaluations. chi2 tests were used to determine differences in cervical cytologic and histologic findings and the proportion of false-positive results across contraceptive groups. Nominal logistic regression was used to evaluate the association between contraceptive use, cervical, and histologic abnormalities while controlling or age and smoking status. RESULTS: The mean age of all participants was 23.5 years, with no significant difference between OC (n = 1194) and DMPA (n = 375) users. Although there were no differences in the proportion of false-positive cytologic results (21.8% overall), DMPA users were more likely to smoke (p < .001), have atypical glandular cell (AGC) on referral cytology (p < .001), and have histologic confirmation of cervical intraepithelial neoplasia 2, 3 (p = .004). Users of DMPA remained more likely to have AGC cytology after considering smoking status; however, cervical intraepithelial neoplasia 2, 3 was found to be associated with smoking status and not use of DMPA. CONCLUSIONS: We found no difference in the proportion of false-positive cytologic results between DMPA and OC users referred for evaluation of abnormal cytology. Users of DMPA were more likely to have AGC, which necessitates a more comprehensive evaluation.
Adolescent, Adult, Cervical Intraepithelial Neoplasia/epidemiology/etiology/pathology, Cervix Uteri/pathology, Colposcopy/standards, Contraceptive Agents, Female/adverse effects, Contraceptives, Oral/adverse effects, Delayed-Action Preparations, False Positive Reactions, Female, Humans, Iowa/epidemiology, Logistic Models, Medroxyprogesterone Acetate/adverse effects, Retrospective Studies, Risk Factors, Smoking/adverse effects, Uterine Cervical Neoplasms/epidemiology/etiology/pathology, Young Adult
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