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author:("Feng, xinghua")
1.  Depot-medroxyprogesterone Acetate and Combined Oral Contraceptive Use and Cervical Neoplasia among Women with Oncogenic Human Papillomavirus Infection 
Objective
Examine the relationship of depot-medroxyprogesterone acetate (DMPA) and combined oral contraceptive (COC) use with cervical intraepithelial neoplasia (CIN).
Study Design
Two case-control studies of women who presented for gynecological care and underwent cytologic and human papillomavirus (HPV) testing were performed. The first included oncogenic HPV-positive women grouped based on histology: negative(n=152), CIN1(n=133), and ≥CIN2-3(n=173). For the second, two groups were identified: negative HPV/negative histology(n=107) and positive oncogenic HPV/negative histology(n=152).
Results
Among oncogenic HPV-positive women, DMPA use was inversely associated with ≥CIN2-3 (adjusted odds ratio[ORadj]=0.4;95% confidence interval[CI]=0.2–1.1) and CIN1 (ORadj=0.1;95% CI=0.01–0.6); COC use was not associated with either. Among histologically negative women, DMPA use was associated with oncogenic HPV (ORadj=4.7;95% CI=1.4–15.8).
Conclusions
Among women with oncogenic HPV, hormonal contraceptive use was not associated with an increased risk of ≥CIN2-3. Longer-term DMPA use may attenuate the colposcopic and histologic features of CIN as women reporting such use were more likely than others to have cervical oncogenic HPV without evidence of CIN.
doi:10.1016/j.ajog.2009.01.030
PMCID: PMC2713031  PMID: 19375566
CIN; hormonal contraception; DMPA; Oncogenic HPV infection

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