Cytologic monitoring of women using copper-containing intrauterine devices: five-year follow-up study.

Cytologic monitoring of the epithelia of the female genital tract in 2,603 women using copper-containing intrauterine devices (Cu IUDs) was carried out, with a detailed cytomorphologic study of the cervical smears. The women were followed-up to a maximum period of 60 months of study. The rate of dysplastic lesions in the initial smears was 2.5%. Grouping the 60 months into five time intervals of one year each, the annual rates of dysplasia at follow-up were 4.2%, 1.6%, 3.8%, 0.9% and 3.0%. The rate of dysplasia development in women with initially negative or inflammatory smears did not change significantly during the five years. No dysplasia progressed to carcinoma during the follow-up period. No difference in the behavior of dysplastic lesions detected at the initial stage as compared to those developing during the course of Cu IUD use was observed during the study. This study indicated that there is no significant risk of an increased incidence of cervical dysplasia or carcinoma development in women using copper-containing IUDs for five years.