The Effect of Intrauterine Contraceptive Device and Oral Contraceptive Pills Use on Pap Smear Results

Authors

  • Haider Jebur Kehiosh Al-Hussein Teaching Hospital -Karbala Health Directorate\ Karbala\ Iraq
  • Hadeer Jabbar Dakhal Al-Hur primary health care Sector- Karbala Health Directorate\ Karbala\ Iraq
  • Esam Shyaa khudhair Al-Hussein Teaching Hospital -Karbala Health Directorate\ Karbala\ Iraq
  • Wasan G. Alsafi College of Medicine – University of Kerbala\ Karbala\ Iraq
  • Salam Sahib Abaid Public Health department- Karbala Health Directorate\ Karbala\ Iraq
  • Ali A. Abutiheen College of Medicine – University of Kerbala\ Karbala\ Iraq

Keywords:

Intrauterine contraceptive device (IUCD), Oral contraceptive pill (OCP), Pap smear, Contraception, Cervical carcinoma, Dysplastic changes

Abstract

Background: Intrauterine contraceptive device (IUCD) oral contraceptive pills (OCP) are widely used contraceptive methods by women. Some concerns had been raised about the role of IUCD and OCP in the development of cervical dysplasia and cancer. And cervical cancer is the fourth most frequent cancer in women, with over half million new cases reported each year. Objectives: To evaluate the effect of IUCD and OCP use on pap-smear results among women in Karbala city. And to assess some factors associated with cervical dysplastic changes. Subjects and methods: A case–control study. Three groups of women were categorized according to the use of OCP, IUCD, or other contraceptive methods for one year accordingly. Pap smears were taken for them and reports were reviewed by a consultant cytopathologist. A total of  237 cases were collected.  Results: The three groups had no significant difference in age, parity, or duration of contraceptive method used. Most Pap smear results were normal, 29 (12.2%) had inflammation and only 7 (3%) showed dysplastic changes and no malignancy change identified among the sample. Inflammatory changes were more prevalent among IUCD users while benign dysplastic changes were more prevalent among women who used other methods of contraception. Dysplastic changes were significantly associated with older age of above 35 years. Conclusion: No association between OCP and IUCD use with abnormal pap-smear results as a significant risk factor for cervical cancer. Inflammatory changes were more prevalent among women who use IUCDs. Dysplastic changes are associated with age over 35 years.

References

- Holt K, Zavala I, Quintero X, Mendoza D, McCormick MC, Dehlendorf C, Lieberman E, Langer A. Women’s preferences for contraceptive counseling in Mexico: results from a focus group study. Reproductive health. 2018 Dec 1;15(1):128.

- National Institutes of Child Health and Human Development (NICHD) Contraception and Birth Control. What are the different types of contraception? available at https://www.nichd.nih.gov/health/topics/contraception/conditioninfo/types . Accessed on 08/09/2016

- Agarwal K, Sharma U, Acharya V. Microbial and cytopathological study of intrauterine contraceptive device users. Indian Journal of Medical Sciences. 2004 Sep 1;58(9): 394-9.

- Mosher WD, Jones J. Use of contraception in the United States: 1982-2008. Vital Health Stat 23. 2010 Aug. 1-44.

- Trussell J. Contraceptive failure in the United States. Contraception. 2011 May. 83(5):39.

- Milton SH, Karjane NW, Chelmow D. Intrauterine device insertion. Medscape reference 2011. Last update at 09.04. 2013.

- Castellsagué X, Díaz M, Vaccarella S, de Sanjosé S, Muñoz N, Herrero R, Franceschi S, Meijer CJ, Bosch FX. Intrauterine device use, cervical infection with human papillomavirus, and risk of cervical cancer: a pooled analysis of 26 epidemiological studies. The lancet oncology. 2011 Oct 1;12(11):1023-31.

- Farcas A, Popa AD, Mardale S, Bucsa C, Leucuta DC, Mogosan C. Counselling, Knowledge and Attitudes towards Combined Oral Contraceptives: A Cross-Sectional Survey among Romanian Women. Farmacia. 2017 Nov 1;65(6):954-61.

- Powell A. Choosing the right oral contraceptive pill for teens. Pediatric Clinics. 2017 Apr 1;64(2):343-58.

- Allen RH, Martin KA. Combined estrogen-progestin oral contraceptives: Patient selection, counseling, and use. UpToDate. https://www. helsebiblioteket. no/(Sist oppdatert: 13. 2020 Apr.

- Dragoman MV. The combined oral contraceptive pill-recent developments, risks and benefits. Best practice & research Clinical obstetrics & gynaecology. 2014 Aug 1;28(6):825-34.

- Healthcare products Regulatory Agency GOV.UK . Hormonal contraceptives: cervical cancer -Published 11 December 2014 available at: https://www.gov.uk/drug-safety-update/hormonal. Accessed on 08/09/2016

- WHO. Human papillomavirus (HPV) and cervical cancer. Last updated 11-11-2020. Available at: https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer accessed on December 5, 2020

- Šarenac T, Mikov M. Cervical cancer, different treatments and importance of bile acids as therapeutic agents in this disease. Frontiers in Pharmacology. 2019 Jun 4;10:484.

- Centers for Disease Control and Prevention . Cervical Cancer is Preventable | Vital Signs | https://www.cdc.gov/vitalsigns/cervical-cancer-2018 accessed at 11/10/2018

- Centers for Disease Control and Prevention. HPV Vaccine Information for Young Women -: December 28, 2016. Accessed on 11-10-2018. available at ://www.cdc.gov › std › stdfact-hpv-vaccine-young-w.

- Mishra GA, Pimple SA, Shastri SS. An overview of prevention and early detection of cervical cancers. Indian journal of medical and paediatric oncology: official journal of Indian Society of Medical & Paediatric Oncology. 2011 Jul;32(3):125-32..

- The American Cancer Society Guidelines for the Prevention and Early Detection of Cervical Cancer. Survival Rates for Cervical Cancer Last Medical Review: October 9, 2017. Available at https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/survival.html accessed on accessed at 11/10/2018

- Lowndes CM. Vaccines for cervical cancer. Epidemiology & Infection. 2006 Feb;134(1):1-2.

- Lakshmi AB, Madhavi BD, Vasundhara M, Sri KS, Vani I, Sreelekha A. Patterns of epithelial cell abnormalities in Pap smears and its clinicopathological and demographic association: a descriptive study from Visakhapatnam city, Andhra Pradesh, India. International Journal of Research in Medical Sciences. 2014 Jan;2(1):300.

- Al-Hemiery N, Dabbagh R, Hashim MT, Al-Hasnawi S, Abutiheen A, Abdulghani EA, et al. Self-reported substance use in Iraq: findings from the Iraqi National Household Survey of Alcohol and Drug Use, 2014. Addiction. 2017;112:1470-9.

- Mao SF, Guo YW, Wang XC. Survey on the prevalence of cervical erosion among women looking for family planning services at nosocomial clinics. Maternal and Child Health Care of China. 2006;2006 (15):35.

- Wright KO, Mohammed AS, Salisu-Olatunji O, Kuyinu YA. Cervical Ectropion and Intra-Uterine Contraceptive Device (IUCD): a five-year retrospective study of family planning clients of a tertiary health institution in Lagos Nigeria. BMC research notes. 2014 Dec 1;7(1):946.

- Abd El All HS, Refaat A, Dandash K. Prevalence of cervical neoplastic lesions and human papilloma virus infection in Egypt: national cervical cancer screening project. Infectious agents and cancer. 2007 Dec;2(1):12.

-Lorand OobonnaAjah,Chilbuike O gwuegbu,Benjamin Ozumba.Association of intrauterine device and cervical Neoplasm_study in apoor Nigeria population.Journal of Clinical and Diagnostic Research. . 2016 Junl;2(7):1150.

- Averbach SH, Ma Y, Smith-McCune K, Shiboski S, Moscicki AB. The effect of intrauterine devices on acquisition and clearance of human papillomavirus. American journal of obstetrics and gynecology. 2017 Apr 1;216(4):386-e1.

- Cortessis VK, Barrett M, Wade NB, Enebish T, Perrigo JL, Tobin J, Zhong C, et al. Intrauterine device use and cervical cancer risk: a systematic review and meta-analysis. Obstetrics & Gynecology. 2017 Dec 1;130(6):1226-36.

- McFarlane-Anderson N, Bazuaye PE, Jackson MD, Smikle M, Fletcher HM. Cervical dysplasia and cancer and the use of hormonal contraceptives in Jamaican women. BMC Women's Health. 2008 Dec;8(1):1-6.

- Dyer O. WHO links long term pill use to cervical cancer. BMJ: British Medical Journal: International Edition. 2002;324(7341):808-9.

- GOV.UK ttps://www.gov.uk › Drug Safety Update 11/12/2014

- National Cancer Institute. Cervical Cancer Prevention (PDQ®)–Health Professional Version available at: https://www.cancer.gov/types/cervical/hp/cervical-prevention-pdq accessed at 22/02/2018

- Tao L, Han L, Li X, Gao Q, Pan L, Wu L, et al. Prevalence and risk factors for cervical neoplasia: a cervical cancer screening program in Beijing. BMC Public Health. 2014 Dec 1;14(1):1185..

- Hinkula M, Pukkala E, Kyyrönen P, Laukkanen P, Koskela P, Paavonen J, Lehtinen M, Kauppila A. A population-based study on the risk of cervical cancer and cervical intraepithelial neoplasia among grand multiparous women in Finland. British journal of cancer. 2004 Mar;90(5):1025-9.

- Khamankar ST, Belekar V, Bhagat VM, Baviskar SR. Cervical cancer screening: risk factors for cervical neoplasia among rural women of nanded maharashtra. Innovative J Med & Health Sci. 2014 Jan 27;4:312-6..

- Özgün G, Aydoğdu G. Distribution of Uterin Cervical Lesions and Relation Between Age and Parity Rates in the Mardin Province/Mardin İlinde Uterin Servikal Lezyonların Dağılımı ve Yaş ve Doğum Sayısı ile İlişkisi. Turkish Journal of Pathology. 2013 Mar 1;29(1):46-50.

Downloads

Published

2021-02-27

Issue

Vol. 20 No. 2 (2020)

Section

ARTICLE