Alcohol Consumption and the Development of High Grade Cervical Dysplasia

Title: Alcohol Consumption and the Development of High Grade Cervical Dysplasia. Objective: To investigate the association between alcohol consumption and prevalence of high grade cervical intraepithelial neoplasia in Duke University cervix clinic patients. Methods: Patients presenting to Duke University Cervix Clinic between the ages of 21 and 65 meeting inclusion criteria were identified and approached to participate in the study.  Once consented, patients completed the Alcohol Use Disorders Identification Test (AUDIT) validated survey. The primary outcome was defined based on colposcopically directed biopsy results. Patients with no Cervical Dysplasia or low grade dysplasia (CIN 1) were placed in one group and those with high grade dysplasia (CIN 2-3) were placed in the other. Demographic information including age, ethnicity, BMI, smoking history, and number of sexual partners was collected. Demographics and patients with harmful alcohol use (AUDIT score of 8 or higher) were compared between the two groups. Results:  Forty-four patients met eligibility criteria and completed the electronic AUDIT survey. Due to a programming error in the RedCap AUDIT questionnaire, 9 surveys were excluded from further analysis. Among 35 patients included in the analysis, 20 patients (57.1%) patients had low grade or no cervical dysplasia and 15 (42.9%) had high grade dysplasia. The proportion of patients with hazardous and harmful alcohol use among those with mild or no cervical dysplasia was 5% (n=1) compared to 6.7% (n=1) among those with high grade cervical dysplasia. There was no significant association between alcohol use and Cervical Dysplasia (p=1.00). There was a significant association between race and high grade cervical dysplasia (p=0.001). Conclusion: In this small pilot study, no statistically significant association was noted between alcohol use per patient’s AUDIT scores and cervical dysplasia. Larger studies are needed to look at this modifiable behavior in decreasing the prevalence of high grade cervical dysplasia and cervical cancer.