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  • Title: [Cytologic observations of cervicovaginal smears during hormonal contraception].
    Author: Ide P, Wijnants P, Bonte J.
    Journal: Rev Cytol Clin; 1972; 5(3):105-12. PubMed ID: 12256654.
    Abstract:
    This is a partial report of a prospective study on cervical cancer among 60,295 Belgian women examined in 1969 and 1970, concerning only those under 50 years of age (43,426 patients) taking combined (2349), sequential (137), or continuous progestogen (482) oral contraceptives for at least 6 months, and 2134 controls matched by age and parity. Cervical and vaginal smears were categorized by Papanicolaou Classes 1-5 , and anomalies in Class 2 included cervicitis, erosion, or metaplasia. There were 1% suspect smears of Class 3, 4, or 5 among combined pill users, over 1% among sequential users, and .2% in continuous progestogen users, compared with .5% in controls. Among Class 1 and 2 patients 60% of combined pill users had clinically pathologic cervices, 54% of sequential users, 47% of continuous progestogen users, but 34% of controls. Among Class 2 smears cervicitis was most common in the combin ed pill group and least common in the sequential group; erosion was rare in the continuous progestogen group; metaplasia was very frequent in the sequential group but rare in the continuous and control groups. Metaplasia was least common among users of continuous medroxyprogesterone, followed by continuous lynestrenol. Metaplasia was correlated with increasing dose of mestranol and with parity. Qualitatively, the parabasal cells appeared to proliferate, especially in multiparas, whereas the superficial and intermediate cells appeared arrested. An anomaly frequently seen in combined pill users was a large nucleus with normal chromatin distribution and staining.
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