Risk Factors for the Pap Test Cytological Changes in Iran: A Multicenter Case-Control Study

Abstract

Background: Pap tests can detect changes inside the cells of the cervix before cancer develops. Objective: To compare the risk factors and determinants for abnormal cytological changes in Pap test results among women with and without atypical cytological findings in their Pap test, and to determine the clinical manifestations associated with those changes. Methods: A multicenter case-control study was conducted in four clinics of gynecology and oncology in Iran. Of a total of 201 women with a result of Pap smear, 51 were cases (atypical cytological findings) and 150 women were control (benign/reactive changes). The data was collected by a researcher-designed tool through the interview, observing medical records and clinical examinations. Results: According to the logistic regression, the women’s age (OR= 1.08), age at the menarche (OR= 0.75), number of deliveries (OR= 1.44), and BMI (OR= 2.60) are the determinants of the Pap test cytological changes in Iran. Taking hormonal contraceptives, using IUD, sexual activity, and having a family history of cancer are not determinants (p>0.05). The clinical manifestations as having an unhealthy cervix, painful sex, low abdominal pain, pelvic pain, and low back pain were significantly higher (P< .001) in the case group than those of the control group. Conclusion: The Pap test cytological changes in Iranian women are associated with age, age at the menarche, number of deliveries, and BMI. This information can help healthcare providers to predict their patients' health situation for taking a suitable and quick action.