Cervical dysplasia and cancer and the use of hormonal contraceptives in Jamaican women
| Autor: | Horace Fletcher, Patience E. Bazuaye, Monica Smikle, Maria D. Jackson, Norma McFarlane-Anderson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2008 |
| Předmět: |
Adult
medicine.medical_specialty Health Knowledge Attitudes Practice Jamaica Population Uterine Cervical Neoplasms Medroxyprogesterone Acetate lcsh:Gynecology and obstetrics Contraceptives Oral Hormonal Risk Factors Obstetrics and Gynaecology Medicine Humans education Cervix lcsh:RG1-991 Cervical cancer Vaginal Smears Medicine(all) education.field_of_study business.industry Obstetrics lcsh:Public aspects of medicine Case-control study Obstetrics and Gynecology lcsh:RA1-1270 General Medicine Odds ratio Middle Aged medicine.disease Uterine Cervical Dysplasia medicine.anatomical_structure Reproductive Medicine Hormonal contraception Family planning Pill Case-Control Studies Women's Health Female Contraceptive Devices business Papanicolaou Test Research Article |
| Zdroj: | BMC Women's Health, Vol 8, Iss 1, p 9 (2008) BMC Women's Health |
| ISSN: | 1472-6874 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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