title: Hormonal contraceptives and the length of their use are not independent risk factors for high-risk HPV infections or high-grade CIN.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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+.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal. longatto@ecsaude.uminho.pt
authors.forename: Adhemar
authors.initials: A
authors.lastname: Longatto-Filho
authors.forename: Luciano Serpa
authors.initials: LS
authors.lastname: Hammes
authors.forename: Luis Otavio
authors.initials: LO
authors.lastname: Sarian
authors.forename: Cecília
authors.initials: C
authors.lastname: Roteli-Martins
authors.forename: Sophie F M
authors.initials: SF
authors.lastname: Derchain
authors.forename: Mojca
authors.initials: M
authors.lastname: Eržen
authors.forename: Margherita
authors.initials: M
authors.lastname: Branca
authors.forename: Sílvio
authors.initials: S
authors.lastname: Tatti
authors.forename: Paulo
authors.initials: P
authors.lastname: Naud
authors.forename: Jean Carlos
authors.initials: JC
authors.lastname: de Matos
authors.forename: Renata
authors.initials: R
authors.lastname: Gontijo
authors.forename: Marina Y S
authors.initials: MY
authors.lastname: Maeda
authors.forename: Temístocles
authors.initials: T
authors.lastname: Lima
authors.forename: Silvano
authors.initials: S
authors.lastname: Costa
authors.forename: Stina
authors.initials: S
authors.lastname: Syrjänen
authors.forename: Kari
authors.initials: K
authors.lastname: Syrjänen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001118:Argentina; D001938:Brazil; D015331:Cohort Studies; D003267:Contraception / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D030361:Papillomavirus Infections / Q000139:chemically induced* / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000209:etiology*