McFarlane-Anderson, N., Bazuaye, P. E., Jackson, M. D., Smikle, M., & Fletcher, H. M. (2008). Cervical dysplasia and cancer and the use of hormonal contraceptives in Jamaican women. BMC women's health, 8(1), 9. https://doi.org/10.1186/1472-6874-8-9
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 Womens Health. 2008;8(1):9. doi:10.1186/1472-6874-8-9
McFarlane-Anderson, Norma, et al. "Cervical dysplasia and cancer and the use of hormonal contraceptives in Jamaican women." BMC women's health, vol. 8, no. 1, 2008, pp. 9.
For EndNote, Zotero or Mendeley:
Open access
No open license is recorded for this paper. Reuse terms are set by the publisher.
Department of Basic Medical Sciences, University of the West Indies, Mona Campus, Kingston, Jamaica. norma.mcfarlaneanderson@uwimona.edu.jm
Linked to ROR, the Research Organization Registry
Abstract
Background
This study was conducted to determine whether use of hormonal contraceptives is associated with cervical dysplasia and cancer in a population where there is widespread use of hormonal contraception and the rates of cervical cancer remain high at 27.5/100,000.
Methods
A case-control study was conducted among women visiting the colposcopy and gynaelogical clinics at a tertiary referral hospital. Two hundred and thirty six cases CIN I (72), II (59), III (54), cancer (51) and 102 controls, consented and were interviewed on use of contraceptives using a structured questionnaire. Logistic regression was used to determine odds ratios (ORs) and 95% confidence intervals (CIs) associated with use of hormonal contraception in cases and controls and in low and high risk cases. Recruitment was carried out from 2001-2002.
Results
Contraceptives used were: oral contraceptives - 35%, injections (depot medroxy progesterone acetate (Depo-provera) - 10%, Intrauterine devices - 2%, combinations of these and tubal ligation - 30%. 23% reported use of 'other' methods, barrier contraceptives or no form of contraception. Barrier contraceptive use was not significantly different between cases and controls. Current and/or past exposure to hormonal contraceptives (HC) by use of the pill or injection, alone or in combination with other methods was significantly higher in the cases. In multivariate analysis with age and number of sexual partners as co-variates, use of hormonal contraception was associated both with disease, [OR, 1.92 (CI 1.11, 3.34; p = 0.02] and severity of the disease [OR, 2.22 (CI 1.05, 4.66) p = 0.036]. When parity and alcohol consumption were added to the model, hormonal contraception was no longer significant. The significant association with high risk disease was retained when the model was controlled for age and number of sexual partners. Depo-provera use (with age and number of sexual partners as covariates) was also associated with disease [OR, 2.43 (CI 1.39, 4.57), p = 0.006] and severity of disease [OR 2.51 (1.11, 5.64) p = 0.027]. With parity and alcohol added to this model, depo-provera use retained significance. Exposure to HC > 4 years conferred more risk for disease and severity of disease.
Conclusion
Hormonal contraception did confer some risk of dysplasia and women using HC should therefore be encouraged to do regular Pap smear screening.
Anastasiou E et al., 2022·Contraception·Free full text on PubMed Central
tudies on the effect of long-term use of combined oral contraceptives (COCs) on cervical dysplasia and/or cancer risk have been inconsistent. Less is known about the effects of other forms of hormonal contraception (HC). We examine whether HC use increases the risk of incident cervical intraepithelial neoplasia (CIN) 2, 3 and/or cancer after accounting for preexisting human papillomavirus (HPV) infection. Systematic review of prospective studies on HC use as risk factor for cervical dysplasia with HPV infection documented prior to outcome assessment including PubMed and EMBASE records between January 2000 and February 2020 (Prospero #CRD42019130725). Among nine eligible studies, seven described recency and type of HC use and therefore comprise the primary analysis; two studies limit comparisons to ever versus never use and are summarized separately. All seven studies explored the relationship between oral contraceptive (OC) use and cervical dysplasia/cancer incidence: two found increased risk (adjusted odds ratio, aOR = 1.5-2.7), one found no association but decreased risk when restricted to women with persistent HPV (adjusted hazard ratio = 0.5), and four found no association. None of the seven studies differentiated between COC and progestin-only pills (POPs) by use recency or duration. The only study that included injectable progestin-only contraception (DMPA) found increased CIN3 incidence among current versus never users (aOR = 1.6). The one study that included Norplant found no association. Two studies included intrauterine device (IUD) use, but did not differentiate between hormonal and copper IUDs, and found no association. We found no consistent evidence that OC use is associated with increased risk for cervical dysplasia/cancer after controlling for HPV infection. There were too few studies of progestin-only injectables, implants or IUDs to assess their effect on cervical dysplasia/cancer risk. Use of single self-reported HC measures and insufficient distinction by hormonal constituent cloud our understanding of whether some HCs increase risk for cervical cancer. Methodologically rigorous studies with distinct HCs measured as time-varying exposures are needed to inform cervical cancer prevention efforts and improve our understanding of cervical cancer etiology.
To determine cervical cancer risk associated with contemporary hormonal contraceptives, we conducted a cohort study of women aged 15 to 49 living in Denmark from 1995 to 2014, using routinely collected information about redeemed prescriptions, incident cancer and potential confounders. Poisson regression calculated adjusted cervical cancer risks among different contraceptive user groups by duration of use, time since last use, hormonal content and cancer histology. During >20 million person-years, 3643 incident cervical cancers occurred. Ever users of any hormonal contraceptives compared to never users had a relative risk (RR) of 1.19 (95% confidence interval [CI] 1.10-1.29). Increased risks were seen in current or recent users of any hormonal: RR 1.30 (95% CI 1.20-1.42) and combined: RR 1.40 (95% CI 1.28-1.53), but not progestin-only contraception: RR 0.91 (95% CI 0.78-1.07). Current or recent users of any hormonal contraception had an increased risk of both adenocarcinoma (RR 1.29, 95% CI 1.05-1.60) and squamous cancer (RR 1.31, 95% CI 1.19-1.44). The risk pattern among any hormonal and combined contraceptive users generally increased with longer duration of use and declined after stopping, possibly taking longer to disappear among prolonged users. Combined products containing different progestins had similar risks. Approximately one extra cervical cancer occurred for every 14 700 women using combined contraceptives for 1 year. Most women in our study were not vaccinated against human papillomavirus (HPV) infections. Our findings reinforce the urgent need for global interventions such as systematic screening, treatment of cervical intraepithelial neoplasia and HPV vaccination programmes to prevent cervical cancer, especially among users of combined contraceptives.
Kusmiyati Y et al., 2019·Kesmas: National Public Health Journal·Free to read
The use of long hormonal contraceptives can disrupt the balance of estrogen in the body, resulting in abnormal cell changes. This study aimed to determine a correlation between the duration of hormonal contraception and risk of cervical cancer. This study used a case-control design. The population were patients who had examined at a cancer installation and obstetrics-gynecology polyclinic Dr. Sardjito Hospital in 2018. Case samples were 95 women have cervical cancer diagnosis and control were 95 women with a negative pap smear. Sampling with random sampling. Dependent variable cervical cancer and independent variable the duration of hormonal contraception are obtained from medical records. Cervical cancer is assessed by doctor’s diagnosis. Data analysis used logistic regression. Results showed that 44.7% of samples used long-term hormonal contraception (over 5 years). Length of use of hormonal contraception had a significant correlation with the incidence of cervical cancer (p-value < 0.01). Hormonal contraceptive use more than 5 years have a risk 4.2 times (95% CI 1.01-5.69) of cervical cancer than using less than 5 years after being controlled with the first marriage age and parity
To assess the risk of oral contraceptives on the occurrence of cervical cancer. Material and A hospital-based case-control study was conducted. Sixty women patients with histologically confirmed invasive cervical cancer and 180 healthy women as the control group who attended the King Chulalongkorn Memorial Hospital, Bangkok, Thailand were recruited. Information about the use of oral contraceptives and other cervical cancer risk factors were obtained from personal interviews. The risk factors were evaluated by using odds ratio (OR). 60 women with invasive cervical cancer and 180 healthy controls were interviewed by the investigators. Compared with non-users, patients who had ever used or currently used oral contraceptive had an increased risk of cervical cancer (OR 1.45; 95% CI 0.79-2.64). However the risk was not statistically significant. Considering the duration of use, patients who had used oral contraceptives for 3 years or less did not have an increased risk of cervical cancer (OR 0.78; 95% CI 0.39-1.77). Nevertheless, the odds ratio of oral contraceptive pill use for more than 3 years was 2.57 (95% CI 1.22-5.49) which was statistically significant. Long-term use of oral contraceptive might be a cofactor that increases the risk of cervical carcinoma. Further investigations should be conducted to confirm this risk. However, Pap smear has to be done routinely in long-term oral pill users.
General Gynecology › Gynecologic Oncology › Cervical Cancer · Contraception › Adverse Effects › Cardiovascular Effects
Patience E Bazuaye, Horace M Fletcher, Maria D Jackson, Norma McFarlane-Anderson, Monica Smikle
P Bazuaye, H Fletcher, M Jackson, N McFarlane-Anderson, M Smikle
PMID 18513406 18513406 DOI 10.1186/1472-6874-8-9 10.1186/1472-6874-8-9 McFarlane-Anderson et al. 2008, McFarlane-Anderson 2008
Cite this article
McFarlane-Anderson, N., Bazuaye, P. E., Jackson, M. D., Smikle, M., & Fletcher, H. M. (2008). Cervical dysplasia and cancer and the use of hormonal contraceptives in Jamaican women. BMC women's health, 8(1), 9. https://doi.org/10.1186/1472-6874-8-9
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 Womens Health. 2008;8(1):9. doi:10.1186/1472-6874-8-9
McFarlane-Anderson, Norma, et al. "Cervical dysplasia and cancer and the use of hormonal contraceptives in Jamaican women." BMC women's health, vol. 8, no. 1, 2008, pp. 9.
03fkc8c64