Diede L Loopik1, Joanna IntHout2, Willem J G Melchers3, Leon F A G Massuger4, Ruud L M Bekkers5, Albert G Siebers6. 1. Department of Obstetrics and Gynaecology, Radboud Institute for Molecular Life Sciences, Radboud university medical center, PO Box 9101, 6500HB, Nijmegen, the Netherlands. Electronic address: diede.loopik@radboudumc.nl. 2. Department of Biostatistics, Radboud Institute for Health Sciences, Radboud university medical center, PO Box 9101, 6585KM, Nijmegen, the Netherlands. Electronic address: Joanna.intHout@radboudumc.nl. 3. Department of Medical Microbiology, Radboud university medical center, PO Box 9101, 6500HB, Nijmegen, the Netherlands. Electronic address: willem.melchers@radboudumc.nl. 4. Department of Obstetrics and Gynaecology, Radboud university medical center, PO Box 9101, 6500HB, Nijmegen, the Netherlands. Electronic address: leon.massuger@radboudumc.nl. 5. Department of Obstetrics and Gynaecology, Catharina Hospital, PO Box 1350, 5602ZA, Eindhoven, the Netherlands. Electronic address: ruud.bekkers@radboudumc.nl. 6. Department of Pathology, Radboud university medical center, PO Box 9101, 6500HB, Nijmegen, the Netherlands; PALGA, Randhoeve 225a, 3995 GA, Houten, the Netherlands. Electronic address: bert.siebers@radboudumc.nl.
Abstract
OBJECTIVE: Hormonal contraceptive use has been associated with the development of cervical cancer, although inconsistent results are reported on the association with intrauterine device (IUD) use. The aim of this study was to evaluate the association between the type of contraceptive use and the development of cervical intraepithelial neoplasia grade III or worse (CIN3+). METHODS: A retrospective population-based cohort study including women aged 29-44 years attending the cervical cancer screening program with normal cytology between 2005 and 2009 identified from the Dutch Pathology Registry. Subgroups with at least 5 years registered use of an oral contraceptive (OC) or IUD were compared with non-users. Risk ratios of CIN3+ were estimated per contraceptive type. RESULTS: 702,037 women were included with a median follow-up of 9.7 years, of which 6705 (0.96%) and 559 (0.08%) women developed CIN3 and cervical cancer, respectively. IUD use was associated with an increased risk of developing CIN3+ (risk ratio (RR) 1.51, 95% confidence interval (CI) 1.32-1.74), and OC use was associated with an increased risk of developing CIN3+ (RR 2.77, 95%CI 2.65-3.00) and cervical cancer (RR 2.06, 95%CI 1.52-2.79). The risk of developing CIN3+ and cervical cancer was higher for OC users compared with IUD users (RR 1.83, 95%CI 1.60-2.09 and RR 1.70, 95%CI 1.00-2.90, respectively). CONCLUSIONS: Both OC use and IUD use were associated with an increased risk of developing CIN3+. However, for women with a contraceptive wish, an IUD seems safer than an OC as the risk of developing CIN3+ and cervical cancer was higher for OC users.
OBJECTIVE: Hormonal contraceptive use has been associated with the development of cervical cancer, although inconsistent results are reported on the association with intrauterine device (IUD) use. The aim of this study was to evaluate the association between the type of contraceptive use and the development of cervical intraepithelial neoplasia grade III or worse (CIN3+). METHODS: A retrospective population-based cohort study including women aged 29-44 years attending the cervical cancer screening program with normal cytology between 2005 and 2009 identified from the Dutch Pathology Registry. Subgroups with at least 5 years registered use of an oral contraceptive (OC) or IUD were compared with non-users. Risk ratios of CIN3+ were estimated per contraceptive type. RESULTS: 702,037 women were included with a median follow-up of 9.7 years, of which 6705 (0.96%) and 559 (0.08%) women developed CIN3 and cervical cancer, respectively. IUD use was associated with an increased risk of developing CIN3+ (risk ratio (RR) 1.51, 95% confidence interval (CI) 1.32-1.74), and OC use was associated with an increased risk of developing CIN3+ (RR 2.77, 95%CI 2.65-3.00) and cervical cancer (RR 2.06, 95%CI 1.52-2.79). The risk of developing CIN3+ and cervical cancer was higher for OC users compared with IUD users (RR 1.83, 95%CI 1.60-2.09 and RR 1.70, 95%CI 1.00-2.90, respectively). CONCLUSIONS: Both OC use and IUD use were associated with an increased risk of developing CIN3+. However, for women with a contraceptive wish, an IUD seems safer than an OC as the risk of developing CIN3+ and cervical cancer was higher for OC users.
Authors: R L Goetgebuer; J E Kreijne; C A Aitken; G Dijkstra; F Hoentjen; N K de Boer; B Oldenburg; A E van der Meulen; C I J Ponsioen; M J Pierik; F J van Kemenade; I M C M de Kok; A G Siebers; J Manniën; C J van der Woude; A C de Vries Journal: J Crohns Colitis Date: 2021-09-25 Impact factor: 9.071