Sexually Transmitted Infections (STIs) increased the risk of precancerous cervical lesions among women in Ethiopia: unmatched case-control study

Objective: This study aimed to identify the determinants of cervical pre-cancerous lesions among women who attend cervical cancer screening in public health facilities. Design: An institution-based, unmatched case-control study was conducted among 216 women (54 cases and 162 controls) from January 2020 to April 2020. Settings: : Selected public health facilities in North Shoa Zone, Amhara, Ethiopia. Participants: Women aged 30 - 49 who were attending cervical cancer screening at health institutions were included in this study. Outcome measures: Cases were women who attended cervical cancer screening and tested positive for Visual Inspection with Acetic Acid (VIA), whereas controls were women who tested negative for VIA. Results: : Women who used oral contraceptives for more than 5 years were approximately 5 times more likely to develop pre-cancerous lesions (Adjusted Odds Ratio (AOR) = 4.75; 95% CI: 1.48, 15.30), and early age at first sexual intercourse (<15 years) increased the odds of developing pre-cancerous lesion by 4 fold (AOR = 3.77; 95% CI: 1.46, 9.69). Women having HIV seropositive results and had a previous history of sexually transmitted infections (STIs) had a 3.4 (AOR = 3.45; 95% CI: 1.29, 9.25) and 2.5(AOR = 2.58; 95% CI: 1.10, 6.09) times more odds of developing cervical pre-cancerous lesions than their counterparts. Conclusions: the use of oral contraceptives for more than five years, early initiation of sex, past and current STI increased the odds of women’s developing pre-cancerous cervical lesions. Awareness creation and the National cervical cancer screening program should prioritize women with identified exposures.