Pelvic inflammatory disease: cumulative incidence in primary care

The cumulative incidence of pelvic inflammatory disease (PID) among 2749 women aged 14-50 making contraception-related visits to 186 randomly selected Calgary family physicians participating in a 1986-1987 cross-sectional survey of physician attitudes and contraceptive prescribing was estimated to be 6.5%. For 10 consecutive working days after the doctors were interviewed, they completed a one-page checklist on every woman making a visit in which contraception was discussed beyond taking a history, including visits where the topic was opened by either the doctor or the patient, or where symptoms were suspected to be related to the use of contraception. Contraception-related visits accounted for 34.7% of all visits to the physicians by women aged 14-50. No definition of PID was provided to the physicians. The history of PID could have been elicited from the patient given or documented by the physician, or diagnosed at the time of the visit. A history of PID was more common among smokers than nonsmokers (11.0% vs 4.3%), and parous than nonparous women (8.8% vs 4.4%). Among women of Caucasian race/ethnicity, 6.2% vs 9.1% of women of other ethnicities had a history of PID. A larger proportion of low income than high income women (8.0% vs 5.3%) had a history of PID. The proportions of women with a PID history did not vary with marital status or age. The estimated 6.5% cumulative incidence is probably an underestimation of the true rate.