title: Effect of the menstrual cycle and hormonal contraceptives on human papillomavirus detection in young, unscreened women.
abstract: OBJECTIVE
  To estimate the effect of the menstrual cycle and oral contraceptive pill (OCP) use on the prevalence, incidence, and persistence of human papillomavirus (HPV).
  
  
  METHODS
  A longitudinal study was conducted among 2,065 women aged 18-29 years. The women returned a self-collected cervicovaginal sample and filled out a questionnaire. A total of 1,812 women participated at all three time points, month 0, month 6, and month 12.
  
  
  RESULTS
  Low- and high-risk HPV prevalence at study entry was 8.9% and 11.8%, respectively. The annual incidence of low-risk HPV infections was 12.5% and the persistence was 2.0%. For high-risk HPV, the incidence and persistence was 12.1% and 4.5%, respectively. These results did not differ between OCP users and nonusers. A significant relationship between high-risk HPV detection and the timing of sampling was found when OCP users and nonusers were analyzed separately. In the second half of the menstrual cycle, high-risk HPV detection decreased in nonusers (P=.007) and increased in OCP users (P=.021). When women used OCPs continuously, high-risk HPV detection returned to the level of the first half of the menstrual cycle.
  
  
  CONCLUSIONS
  High-risk HPV detection was significantly influenced by sample timing in the menstrual cycle when analyzed separately for OCP users and women with a natural menstrual cycle. This may have implications in the future, when high-risk HPV detection may become a primary screening tool in cervical cancer prevention.
  
  
  METHODS
  II.
authors.affiliation: From the Departments of Obstetrics and Gynecology and Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen; and DDL Diagnostic Laboratory, Voorburg, The Netherlands.
authors.forename: Channa E
authors.initials: CE
authors.lastname: Schmeink
authors.forename: Leon F
authors.initials: LF
authors.lastname: Massuger
authors.forename: Charlotte H
authors.initials: CH
authors.lastname: Lenselink
authors.forename: Wim G
authors.initials: WG
authors.lastname: Quint
authors.forename: Willem J
authors.initials: WJ
authors.lastname: Melchers
authors.forename: Ruud L
authors.initials: RL
authors.lastname: Bekkers
mesh_terms: D000293:Adolescent; D000328:Adult; D003278:Contraceptives, Oral, Hormonal / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008597:Menstrual Cycle / Q000502:physiology*; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000821:virology; D015995:Prevalence
chemical_list: D003278:Contraceptives, Oral, Hormonal