Contraceptive methods and premalignant changes of the cervix

The effect of various contraceptive methods, practised by a defined low risk population of women, on pathological findings in cervical cytology was evaluated. A group of 1,099 women, married, aged 17-45, who had had no more than three sexual partners and who shared a common socioeconomic background was divided into two subgroups: 497 women who did not practice any contraceptive method prior to the study, were used as controls, and 602 who practised a single contraceptive method at the beginning of the study (intrauterine contraceptive device, oral contraceptives, condoms or spermicides) formed the study group. The rate of each of the following possible pathological findings in the study group normal cytology; inconclusive, atypical metaplasia; human papillomavirus infection and CIN I-III - was compared with the corresponding rate of the control group. We found a significantly higher rate of CIN (p<0.05) in the spermicide users subset and a significant difference in the rate of all pathologies found on cervical cytology in the same subgroup. A tendency towards significance (p=0.06) was found in the rate of CIN in the oral contraceptives (OC) users subgroup. In the light of these findings we recommend routine cytological follow-up of women practising contraceptive methods.