Cervical neoplasia risk in women provided hormonal contraception without aPap smear

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.