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Cervical human papillomavirus detection is not affected by menstrual phase
  1. Joseph E Tota1,2,
  2. Agnihotram V Ramanakumar1,
  3. Salaheddin M Mahmud1,3,4,
  4. Andrea Trevisan5,
  5. Luisa L Villa5,
  6. Eduardo L Franco1,2,
  7. the Ludwig-McGill Cohort Study Group
  1. 1Department of Oncology, McGill University, Montreal, Canada
  2. 2Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
  3. 3Department of Surgery, McGill University, Montreal, Canada
  4. 4Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
  5. 5Ludwig Institute for Cancer Research, São Paulo, Brazil
  1. Correspondence to Professor Eduardo L Franco, Division of Cancer Epidemiology, McGill University, 546 Pine Avenue, West Montreal, QC, Canada H2W 1S6 eduardo.franco{at}


Objectives In many settings, human papillomavirus (HPV) DNA testing already plays an important role in cervical cancer screening. It is unclear whether hormonal fluctuations associated with menstrual phase or oral contraceptive (OC) use have any effect on HPV detection. We evaluated the effects of OC use and timing of cervical sampling in relation to women's last menstrual period (LMP) on HPV detection, and viral load in the Brazilian Ludwig–McGill cohort study.

Methods Women in the cohort were followed every 4–6 months, and at each clinic visit they were asked to complete a questionnaire and to provide a cervical sample for HPV testing. Specimens from 6093 patient visits (n=2209 women) were categorised according to date of LMP into four distinct phases: follicular (days 5–9), midcycle (days 10–15), luteal (days 16–22), or late luteal (days 23–31).

Results Compared with follicular phase (referent group), HPV detection did not differ according to reported LMP for midcycle (OR=1.14, 95% CI 0.95 to 1.37), luteal (OR=1.03, 95% CI 0.85 to 1.25), or late luteal menstrual phase (OR=1.01, 95% CI 0.83 to 1.24), and was also not influenced by OC use. Analyses restricted to high-risk HPV types (grouped) and HPVs 16 and 18 (separately), produced similar non-significant associations. For HPV-positive samples, we found that the menstrual phase did not influence the total viral load.

Conclusions These results indicate HPV detection is not associated with menstrual phase. Our findings suggest that standardising the timing of specimen collection for HPV testing is not necessary.

  • HPV
  • Dna Amplification
  • Menstrual Cycle
  • Screening
  • Epidemiology (Molecular)

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