The impact of intrauterine contraceptive devices on cytological findings from routine Pap smear testing

Objective To evaluate the impact of intrauterine contraceptive device (IUCD) use on the interpretation of routine Pap smears. Study design A retrospective case-control study. Patients and methods During a 2-year period, we evaluated the Papanicolaou (Pap) tests of 452 consecutive asymptomatic women of childbearing age who used a copper IUCD (study group), and 452 matched controls who practiced no contraceptive methods (control group). Results Inflammatory exudate, inflammatory epithelial changes or extensive metaplastic cells were more commonly encountered among the IUCD users as compared with nonusers (p < 0.05). No difference was noted in the detection rates of cervical squamous intraepithelial lesions in the two study groups. Conclusions It can therefore be concluded that the use of an IUCD does not increase the incidence of squamous intraepithelial lesions. Any abnormal Pap smear in an IUCD user should first be repeated after local vaginal treatment, if only to temporarily palliate the inflammatory cellular reaction which impedes unequivocal interpretation of the routine Pap smear.