Assessment of cervical cytological atypia among oral hormonal contraceptive pills users in Khartoum Teaching Hospital

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Mohammed, Yousif
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University of Khartoum
This is a retrospective cohort case control study, conducted in Khartoum Teaching Hospital (Fath El Rahman Elbashir center) during the period from May 2004-Oct 2005 in order to assess the cervical cytological atypia and its degrees among OC pills users by the use of cytological methods. The study assessed the cytological changes in the cervix among 100 subjects. Of whom, 50 were Oral Contraceptive (OC) pills users (cases), and 50 subjects were non-OC pills users (controls). Analysis of the cytological smears identified atypia among 9(9%) subjects, and no atypia among the remaining 91(91%) subjects. Of the 9 atypical changes, 7(78%) were detected among cases and only 2(22%) among controls. These findings indicating that OC pills use is a risk factor for cervical cancer, and this was found to be statistically significant (P<0.006). Of the 7 atypical changes among cases, 5(71%) showed mild dyskaryosis and the remaining 2(29%) showed moderate dyskaryosis. The 2 atypical smears among control group were found with mild dyskaryosis. Although, atypical changes appeared after short periods of OC pills use (>1year), the risk for atypia was increasing with the increase of age (P<0.007). Fungal infections were detected among 5(10%) of the study subjects. Of these, 4(80%) were detected among cases and only 1(20%) among controls. These findings indicating that OC pills use increasing the rate of fungal infection, and this was found to be statistically significant (P<0.001). Factors such as duration of OC use, number of child birth should be considered when assessing cervical cytology. Exfoliated cytology appears to be of value in detection of pre-malignant and malignant lesions. OC pills users should undergo interval cytological screening programes.
100 Pages
cervical cytological atypia,oral hormonal contraceptive pills;Aetiology of cervical; carcinoma;cervical smears