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Federación Mexicana de Ginecología y Obstetricia, A.C.

2005, Number 02

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Ginecol Obstet Mex 2005; 73 (02)

Influence of the use of oral contraceptives as risk factors for human papillomavirus infection and cervical intraepithelial neoplasia

Lucía SE, González JL, Olmos A, Calzada L

Language: Spanish
References: 25
Page: 83-89
PDF size: 83.58 Kb.


ABSTRACT

Objective: To study the influence of oral contraception use as risk factor for human papillomavirus infection (HPV) and progression to cervical intraepithelial neoplasia (CIN).
Materials and methods: A prospective, transversal and comparative study of 84 female patients in reproductive age that had used oral contraception for more than three years as birth control method and who had CIN mild (CIN I), moderate (CIN II) or severe (CIN III) associated or not to HPV infection documented by colposcopy, pathology and cytology was done. 84 cases and 60 controls submitted to a directed interrogation were studied. Differences among groups were determined by linear regression, multivariance and logistic regression tests. p ‹0.05 was considered statistically significant.
Results: Average age for cases and controls was 37.5 and 36.2 years, respectively. The 70% of patients started their active sexual life in the second decade of their life. The most frequent age was 18 and 19 years. 50.6% of these patients had more than one sexual partner, two in average. 67.8% of cases had HPV infection and applying the multivariance analysis: sexual partners (p ‹ 0.05), age at first pregnancy (p ‹ 0.05) and oral contraception use (p ‹ 0.05) were considered statistically significant. According to the CIN grade, the HPV presence was found as highly statistically significant (p ‹ 0.001). Oral contraception use was found as risk factor for HPV infection by logistic regression (p = 0.0242); OR = 3.2714; CI = 1.1670-9.1702. As for the CIN degree, HPV presence was found as highly significant (p = 0.0001); OR = 2.4158; CI = 1.7150-3.4028.
Conclusion: A high incidence of HPV was found in our study. This is an important risk factor during cellular transformation, so the use of oral contraception as birth control method could accelerate the viral oncogenes expression present in HPV cellular genome. It is highly recommended to discard HPV infection before prescribing oral contraception as birth control method.


REFERENCES

  1. Olvera RA, Quiroz PS, Pérez LJCJ, De la Rosa MV. Displasia cervical y carcinoma cervicouterino: un reto para los servicios de salud. Ginec Obst Mex 1998;66:232-6.

  2. Salud Pública de México 2004;46:165-85.

  3. García SM. Frecuencia relativa del cáncer en el Hospital de Oncología. Rev Med del IMSS 1991;92:355-9.

  4. Stephen AC, Nilof MJ. Cancer of the utherin cervix. N Engl J Med 1996;334:1030-6.

  5. Verduzco RL, Palet GJA, Aguirre GH, González PE. Cáncer cérvico uterino y edad. Ginec Obst Mex 1997;65:119-22.

  6. Brisson J, Morin C, Fortier M, Roy M, Bouchard C, Leclerc J. Risk factors for cervical intraepithelial neoplasia: differences between low-and high-grade lesions. Am J Epidemiol 1994;40:700-10.

  7. Jones CJ, Brinton LA, Hamman RF, Stolley PA, Lehman HF, Levine RS. Risk factors for in situ cervical cancer: results from a case-control study. Cancer Res 1990;50:3657-62.

  8. Sánchez VJT, Torres EM, Tay ZJ, Ruiz SC, Romero CR. Frecuencia de la neoplasia intraepitelial del cuello uterino y factores de riesgo en mujeres de la Ciudad de México. Ginec Obst Mex 1996;65:3-7.

  9. Schiffman MH, Haley NJ, Felton JS, Andrews AW, Kaslow RA, Lancaster WD. Biochemical epidemiology of cervical neoplasia: Measuring cigarette smoke constituents in the cervix. Cancer Res 1987;47:3886-88.

  10. Tran-Thanh D, Provencher D, Kovshik A, Duarte-Franco E, Kessous A, Drovin P. Herpes simplex virus type II is not a cofactor to human papillomavirus in cancer of the uterine cervix. Am J Obstet Gynecol 2003;188:129-34.

  11. Zur-Hauzen H. Human papillomavirus in the pathogenesis of anogenital cancer. Virology 1991;184:9-13.

  12. Altekruse SF, Lacey JV Jr, Brinton LA, Gravitt PE, Silverberg SG, Barnes WA. Comparison of human papillomavirus genotypes, sexual, and reproductive risk factors of cervical adenocarcinoma and squamous cell carcinoma: Northestern United States. Obstet Gynecol 2003;188:657-63.

  13. De Villiers EM. Relationship between steroid hormone contraceptives and HPV, cervical intraepithelial neoplasia and cervical carcinoma. Int J Cancer 2003;103:705-9.

  14. Salazar EL, Sojo AI, López R. The evidence of an etiological relationship between oral contraceptive use and dysplasic changes in cervical tissue. Gynecol Endocrinol 2000;13:1-6.

  15. Pater MM, Mittal R, Pater A. Role of steroid hormones in potentiating transformation of cervical cells by human papillomavirus. Trends Microbiol 1994;2:229-35.

  16. Pater A, Bayatpour M, Pater MM. Oncogenic transformation by human papillomavirus type 16 deoxyribonucleic acid in the presence of progesterone or progestins from oral contraceptives. Am J Obstet Gynec 1990;162:1099-103.

  17. Salazar EL, Mercado PE, Sojo AI. Relationship between estradiol 16a-hydroxylation and human papillomavirus infection in cervical cell transformation. Gynecol Endocrinol 2001;15:335-40.

  18. La Vecchia C, Tavani A, Franceschi S, Parazzini F. Oral contraceptive and cancer. A review of the evidence. Drugs Safety 1996;14:260-72.

  19. Salazar EL, Roman MA, González SJ. Progesterone receptor values in human papilloma virus infection and cervical intraepithelial neoplasia. Med Sci Res 1997;25:511-2.

  20. Nonogaki H, Fujii S, Konishi I, Nanbu Y, Ozaki S, Ishikawa Y. Estrogen receptor localization in normal and neoplastic epithelium of the cervix. Cancer 1990;66:2620-7.

  21. Berumen J, Casas L, Segura E, Amescua JL, García-Carrancá. Genome amplification of human papillomavirus types 16 and 18 in cervical carcinomas is related to the retention of E1/E2 genes. Int J Cancer 1997;56:640-5.

  22. Mitrani-Rosenbaum S, Tsvieli R, Tur-Kaspa R. Oestrogen stimulates differential transcription of human papillomavirus type 16 in SiHa cervical carcinoma cells. J Gen Virol 1989;70:2227-232.

  23. Salazar EL, Roman AM, González SJ. Hormone receptors status in cervical intraepithelial neoplasia: correlation with the stage of disease. Med Sci Res 1999;27:681-3.

  24. Brinton LA, Reeves WC, Brenes MM, Herrero R, Britton RC, Gaitan E. Oral contraceptive use and risk of invasive cervical cancer. Inter J Epidemiol 1990;19:4-11.

  25. Salazar EL, Torres JA, Avila A, Andrade A. Hyperplastic changes and receptors status in the breast tissue of bodybuilders under anabolic-androgenic steroid stimulation. Arch Androl 2000;45:1-7.




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