Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal.
Gynecol Obstet Invest. 2011;71(2):93-103. doi: 10.1159/000320742. Epub 2010 Dec 9.
To evaluate the role of hormonal contraceptives as a risk factor of high-risk human papillomavirus (HR-HPV), cervical intraepithelial lesions (CIN) and cervical cancer in our multi-center population-based LAMS (Latin American Screening) study.
A cohort study with >12,000 women from Brazil and Argentina using logistic regression to analyze the covariates of hormonal contraception (HOC - oral, injections, patches, implants, vaginal ring and progesterone intrauterine system) use followed by multivariate modeling for predictors of HR-HPV and CIN2+.
HR-HPV infection was a consistent risk factor of high-grade CIN in all three groups of women. The length of HOC use was not significantly related to high-grade squamous intraepithelial lesions (HSIL)+ Pap (p = 0.069), LSIL+ Pap (p = 0.781) or ASCUS+ (p = 0.231). The same was true with the length of HOC use and histology CIN3+ (p = 0.115) and CIN2+ (p = 0.515). Frequently, HOC users have previously shown more HPV-related lesions, as well as lower HPV prevalence if they were current smokers. But HOC use and time of usage were not independent risk factors of either HR-HPV infection or high-grade CIN using multiple logistic regressions.
No evidence was found for an association between the use of HOC with an increased risk for HR-HPV infection or high-grade CIN in this cohort.
评估激素避孕药作为高危型人乳头瘤病毒（HR-HPV）、宫颈上皮内病变（CIN）和宫颈癌的危险因素在我们多中心人群为基础的 LAMS（拉丁美洲筛查）研究中的作用。
对来自巴西和阿根廷的超过 12000 名女性进行队列研究，使用逻辑回归分析激素避孕药（HOC-口服、注射、贴片、植入物、阴道环和孕激素宫内节育器）使用的协变量，然后进行多变量建模分析 HR-HPV 和 CIN2+的预测因素。
HR-HPV 感染是所有三组女性中高级别 CIN 的一致危险因素。HOC 使用时间与高级别鳞状上皮内病变（HSIL）+ Pap（p = 0.069）、低度鳞状上皮内病变（LSIL）+ Pap（p = 0.781）或非典型意义不明确的鳞状上皮细胞（ASCUS）+（p = 0.231）之间无显著相关性。同样，HOC 使用时间与组织学 CIN3+（p = 0.115）和 CIN2+（p = 0.515）之间也无显著相关性。经常，HOC 使用者之前表现出更多的 HPV 相关病变，如果他们是当前吸烟者，则 HPV 患病率较低。但使用 HOC 和使用时间不是多重逻辑回归分析中 HR-HPV 感染或高级别 CIN 的独立危险因素。
在本队列中，没有证据表明 HOC 使用与 HR-HPV 感染或高级别 CIN 风险增加之间存在关联。
