High parity and hormonal contraception use as risk factors for cervical cancer in East Kalimantan

Swandari Paramita, Soetomo Soewarto, M. Aris A. Widodo, Sutiman B. Sumitro

DOI: https://doi.org/10.13181/mji.v19i4.414


Aim: To find risk factors associated with cervical cancer.

Methods: This a case-control study conducted in A.W. Sjahranie County General Hospital at Samarinda East Kalimantan from January until July 2009. There were 58 patients for each case and control group. Variables in this study were age, menarche, menopause, age of first marriage, parity, spouse’s smoking status, hormonal contraception use, type of hormonal contraception, duration of hormonal contraception, IUD (intra uterine device) contraception use and duration of IUD contraception.

Results: final data analysis shows that parity and duration of hormonal contraception use increased the risk of cervical cancer. Women who had 5-12 children than 0-4 children had 2.6-folds increased risk to be cervical cancer. Compared to women never use of hormonal contraception, those who ever had hormonal contraception for 1-4 years and 5-25 years had two time and 4.5 times increased risk to be cervical cancer respectively.

Conclusion: Cervical cancer screening recommended to be focused on high-risk groups, among others, women with the number of children born more than fi ve people or women in particular users of hormonal contraception methods with a range of use more than fi ve years. (Med J Indones 2010; 19:268-72)

Keywords: Cervical cancer, hormonal contraception, menarche, parity

Full Text:



  1. World Health Organization. World: Human Papillomavirus
  2. and Related Cancer, Summary Report Update 2010. Geneva:World Health Organization. 2010;8-14.
  3. World Health Organization. Indonesia: Human Papillomavirus
  4. and Related Cancer, Summary Report Update 2010. Geneva:
  5. World Health Organization. 2010;6-11.
  6. Castellsagué X, Muñoz N. Chapter 3: Cofactors in
  7. human papillomavirus carcinogenesis- role of parity, oral
  8. contraceptives, and tobacco smoking. JNCI Monographs.
  9. ;31: 20-8.
  10. Moreno V, Bosch FX, Muñoz N, Meijer CJ, Shah KV,
  11. Walboomers JM, et al. International agency for research on
  12. cancer, multicentric cervical cancer study group. Effect of
  13. oral contraceptives on risk of cervical cancer in women with
  14. human papillomavirus infection: The IARC Multicentric
  15. Case-Control Study. Lancet. 2002;359:1085-92.
  16. Muñoz N, Franceschi S, Bosetti C, Moreno V, Herrero R, Smith
  17. JS, et al. International agency for research on cancer, ulticentric cervical cancer study group. Role of parity and human
  18. papillomavirus in cervical cancer: The IARC Multicentric Case-
  19. Control Study. Lancet. 2002; 359:1093-101.
  20. Castellsagué X, Díaz M, de Sanjosé S, Muñoz N, Herrero
  21. R, Franceschi S, et al. Worldwide human papillomavirus
  22. etiology of cervical adenocarcinoma and its cofactors:
  23. implications for screening and prevention. JNCI.
  24. ;98:303-15.
  25. Hildesheim A, Herrero R, Castle PE, Wacholder S, Bratti
  26. MC, Sherman ME et al. HPV co-factors related to the
  27. Paramita et al. Med J Indones development of cervical cancer: results from a populationbased study in Costa Rica. Br J Cancer. 2001; 84: 1219-26.
  28. Thomas DB, Ray RM, Koetsawang A, Kiviat N, Kuypers J,
  29. Qin Q, et al. Human papillomaviruses and cervical cancer
  30. in Bangkok. I. Risk factors for invasive cervical carcinomas
  31. with human papillomavirus types 16 and 18 DNA. Am J
  32. Epidemiol. 2001;153:723-31.
  33. Bayo S, Bosch FX, de Sanjosé S, Muñoz N, Combita AL,
  34. Coursaget P, et al. Risk factors of invasive cervical cancer
  35. in Mali. Int J Epidemiol. 2002; 31: 202-9.
  36. Kjellberg L, Hallmans G, Ahren AM, Johansson R, Bergman
  37. F, Wadell G, et al. Smoking, diet, pregnancy and oral contraceptive use as risk factors for cervical intra-epithelial
  38. neoplasia in relation to human papillomavirus infection. Br
  39. J Cancer. 2000;82:1332-8.
  40. De Boer MA, Vet JN, Aziz MF, Cornain S, Purwoto G, van
  41. den Akker BE, et al. Human papillomavirus type 18 and other risk factors for cervical cancer in Jakarta, Indonesia. Int J Gynecol Cancer. 2006;16:1809-14.
  42. International Collaboration of Epidemiological Studies
  43. of Cervical Cancer, Appleby P, Beral V, Berrington de González A, Colin D, Franceschi S, et al. Cervical cancer and hormonal contraceptives: Collaborative reanalysis of individual data for 16,573 women with cervical cancer and 35,509 women without cervical cancer from 24 epidemiological studies. Lancet. 2007;370: 1609-21.
  44. Madeleine MM, Daling JR, Schwartz SM, Shera K, McKnight B, Carter JJ, et al. Human papillomavirus and long-term oral contraceptive use increase the risk of adenocarcinoma in situ of the cervix. Cancer Epidemiol Biomarkers Prev. 2001;10:171-7.
  45. Vanakankovit N, Taneepanichskul S. Effect of oral contraceptives on risk of cervical cancer. J Med Assoc Thai.
  46. N, Triaspolitica. "Mengenal Penyakit Kanker, Jenis, Gejala, Penyebab Berikut Pengobatan Kanker." Mau Nanya Dong Dok. N.p, 20 June 2017. Web. 28 June 2017. <https://nanyadongdok.blogspot.com/2017/06/mengenal-penyakit-kangker-jenis-gejala.html>.

Copyright (c) 2010 Swandari Paramita, Soetomo Soewarto, M. Aris A. Widodo, Sutiman B. Sumitro

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

All articles and issues in Medical Journal of Indonesia have unique DOI number registered in Crossref.