The study was conducted to determine whether women using a demonstration pr
ogram providing hormonal birth control without concurrent pelvic examinatio
n (First Stop) are at higher risk of cervical neoplasia compared to women u
sing traditional family planning clinics. Using retrospective abstraction o
f medical charts, we compared risk factors for cervical neoplasia among 400
First Stop clients and 400) traditional site clients matched on age, race,
and contraceptive method. We determined prevalence of these factors: previ
ous abnormal cervical smear, <16 years at first intercourse, multiple sexua
l partners, high parity, history of sexually transmitted infections, and cu
rrent cigarette smoking. First Stop clients were not at greater likelihood
of having any risk factor for cervical neoplasia except high parity. First
Stop clients who failed to follow through on a referral to a traditional cl
inic were not more likely to be of higher risk than those who did follow th
rough. Of 13 First Stop clients with the highest risk profiles (previous ab
normal cervical smear plus one other risk factor), one did not follow throu
gh with referral. First Stop clients choosing hormonal contraception withou
t a pelvic examination do not appear to be at substantially higher risk of
cervical neoplasia. Future research should quantify more precisely the risk
s and benefits of the general application of this strategy on a population
level. <(c)> 2001 Elsevier Science Inc. All rights reserved.