title: Cervical human papillomavirus detection is not affected by menstrual phase.
abstract: OBJECTIVE
  In many settings, human papillomavirus (HPV) DNA testing already plays an important role in cervical cancer screening. It is unclear whether hormonal fluctuations associated with menstrual phase or oral contraceptive (OC) use have any effect on HPV detection. We evaluated the effects of OC use and timing of cervical sampling in relation to women's last menstrual period (LMP) on HPV detection, and viral load in the Brazilian Ludwig-McGill cohort study.
  
  
  METHODS
  Women in the cohort were followed every 4-6 months, and at each clinic visit they were asked to complete a questionnaire and to provide a cervical sample for HPV testing. Specimens from 6093 patient visits (n=2209 women) were categorised according to date of LMP into four distinct phases: follicular (days 5-9), midcycle (days 10-15), luteal (days 16-22), or late luteal (days 23-31).
  
  
  RESULTS
  Compared with follicular phase (referent group), HPV detection did not differ according to reported LMP for midcycle (OR=1.14, 95% CI 0.95 to 1.37), luteal (OR=1.03, 95% CI 0.85 to 1.25), or late luteal menstrual phase (OR=1.01, 95% CI 0.83 to 1.24), and was also not influenced by OC use. Analyses restricted to high-risk HPV types (grouped) and HPVs 16 and 18 (separately), produced similar non-significant associations. For HPV-positive samples, we found that the menstrual phase did not influence the total viral load.
  
  
  CONCLUSIONS
  These results indicate HPV detection is not associated with menstrual phase. Our findings suggest that standardising the timing of specimen collection for HPV testing is not necessary.
authors.affiliation: Division of Cancer Epidemiology, McGill University, 546 Pine Avenue, West Montreal, QC, Canada.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Tota
authors.forename: Agnihotram V
authors.initials: AV
authors.lastname: Ramanakumar
authors.forename: Salaheddin M
authors.initials: SM
authors.lastname: Mahmud
authors.forename: Andrea
authors.initials: A
authors.lastname: Trevisan
authors.forename: Luisa L
authors.initials: LL
authors.lastname: Villa
authors.forename: Eduardo L
authors.initials: EL
authors.lastname: Franco
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D002584:Cervix Uteri / Q000821:virology*; D015331:Cohort Studies; D003276:Contraceptives, Oral / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008597:Menstrual Cycle; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D019562:Viral Load; D055815:Young Adult
chemical_list: D003276:Contraceptives, Oral