Background: Combined oral contraceptive pills (COCs) are widely used as contraceptive method. Some authors linked prolonged use of COCs to development of cervical intra-epithelial neoplasia (CIN). However, this link need more investigations to be proven.
The aim of the study: was to assess the association between the long term use of combined oral contraceptive pills and the development of cervical intra-epithelial neoplasia.
Patients & methods: This cross-sectional observational study was carried out in outpatient clinic of Obstetrics & Gynecology Department and Department of Pathology at Zagazig University Hospitals, Zagazig, Sharkia, Egypt, from December 2017 till January 2019. One hundred and thirty six cases were included. All women were currently using COCs or previously used it. Full history was taken from all women, PAP smear was taken, fixed on glass slide by alcohol 95%, then staining with Papanicolaou stain and finally interpretation of the results using Bethesda system 2014 was done.
Results: Abnormal PAP smear was correlated with the duration of COCs use, the longer the duration of COCs use, the higher the grade of abnormal PAP smear. Other factors that correlate positively with abnormal PAP smear in COC users were older age, longer marital life and higher parity (> 3). On the contrary, mode of delivery, history of cervical cauterization or complaint of vaginal discharge had no impact.
Conclusion: Positive association was noticed between the duration of COCs use and abnormal PAP smear and between its long term use and the higher grade of the abnormal PAP smear.