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

  • 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


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.


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