DETERMINANTS OF CERVICAL ECTOPIA AND OF CERVICITIS - AGE, ORAL CONTRACEPTION, SPECIFIC CERVICAL INFECTION, SMOKING, AND DOUCHING

OBJECTIVE: Our purpose was to assess determinants of cervical ectopia and cervicitis, specifically after adjustment for cervical infection. STUDY DESIGN: A cross-sectional study was conducted with colposcopic, cytologic, and microbiologic examination of 764 randomly selected wome n attending a sexually transmitted disease clinic and 819 consecutive college students undergoing routine annual examination. RESULTS: After we controlled for potential confounders, cervical ectopia was positiv ely associated with oral contraception and Chlamydia trachomatis infec tion and negatively associated with aging in both populations, with re cent vaginal doughing in patients with sexually transmitted diseases, and with current smoking in college students. Oral contraception was a lso associated with the radius of ectopia, and among users of oral con traception ectopia was associated with duration of oral contraception. Cervicitis (evaluated by Gram stain, Papanicolaou smear, and colposco py) was associated with cervical infection by C. trachomatis and cytom egalovirus (both populations) and with gonorrhea and cervical herpes s implex virus infection (patients with sexually transmitted diseases). Cervicitis was independently associated with ectopia but not with oral contraception after we adjusted for these four cervical infections. H owever, oral contraception was associated with edema and erythema of t he zone of ectopia among women without cervical infection. CONCLUSIONS : Oral contraception, aging, cervical infection, smoking, and douching have effects on cervical ectopia that may influence the acquisition, transmission, or effects of sexually transmitted agents. Ectopia is as sociated with young age, oral contraception, and cervical infection; c ervicitis is associated with ectopia and cervical infection by C. trac homatis, Neisseria gonorrhoeae, herpes simplex virus, and cytomegalovi rus. In women without cervical infection, edema and erythema of the zo ne of ectopia are associated with oral contraception.