• C Rousset-Jablonski, Q Reynaud, M Perceval, R Nove-Josserand, S Durupt, I Ray-Coquard, F Golfier, and I Durieu.
• Hospices civils de Lyon, CRCM-Centre Hospitalier Lyon Sud, 165 chemin du grand revoyet, Pierre-Bénite 69310, France; Department of Gynaecological Surgery and Oncology, Obstetrics, Lyon Sud University Hospital, Hospices Civils de Lyon, 165 chemin du grand Revoyet, Pierre-Bénite 69310, France; Université Claude Bernard Lyon 1 - HESPER EA7425, 8 avenue Rockefeller, Lyon cedex 8 69373, France; Departement of Surgery, Leon Bérard Cancer Center, 28 rue Laënnec, Lyon 69008, France. Electronic address: rousset-jablonski@chu-lyon.fr.
• Contraception. 2020 Mar 1; 101 (3): 183-188.

ObjectiveOur study aimed to evaluate the impact of the introduction of a new gynecologic referral service in our adult Cystic Fibrosis (CF) center on contraceptive coverage, gynecological follow-up regularity, and cervical cancer screening coverage.Study DesignWe implemented an on-site gynecological consultation in our adult CF center in 2015. We compared the results of two surveys conducted successively in 2014 and in 2017 in a cohort of women with CF attending the Lyon CF center. Women completed the same self-report written questionnaire as in 2014. Main outcome measures were the comparisons of contraceptive coverage, gynecological follow-up regularity, and cervical cancer screening coverage between 2014 and 2017.ResultsAll the 136 women (100%) who attended the clinic in 2017 participated. Contraceptive prevalence rate increased from 69%(CI95%:60.3-78.1) to 86%(CI95%:79.6-92.9) between 2014 and 2017 (p = 0.005). Among transplanted patients, the contraceptive prevalence rate was 92.3%(CI95%:82.0-100) in 2017. Long acting reversible contraceptive use markedly increased from 10% to 21.6% (p = 0.005). The proportion of women that reported an access to gynecological care increased between 2014 and 2017 (74%(CI95%:66.3-82.0) vs 91%(CI95%:86.9-95.4), p < 0.005) and reached 100% among transplanted patients. Cervical cancer screening improved (55%(CI95%:51.2-68.8) vs 85%(CI95%:78.6-90.6) women ever screened) (p < 0.0005) and reached 100% among transplanted patients.ConclusionsWe observed an improvement in contraceptive coverage and gynecological care of adult women with CF following the implementation of a dedicated gynecological consultation in the CF center.ImplicationsService linkages and formal links between CF centers and gynecologists can facilitate access to disease-specific contraceptive counseling, adequate gynecological management and cervical cancer screening.Copyright © 2019 Elsevier Inc. All rights reserved.

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