Format

Send to

Choose Destination
Ann Rheum Dis. 2015 Jul;74(7):1360-7. doi: 10.1136/annrheumdis-2013-204993. Epub 2014 Mar 11.

Risk of high-grade cervical dysplasia and cervical cancer in women with systemic inflammatory diseases: a population-based cohort study.

Author information

1
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, Massachusetts, USA Division of Rheumatology, Allergy and Immunology, Brigham and Women's Hospital, Boston, Massachusetts, USA Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
2
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, Massachusetts, USA.
3
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
4
Department of Obstetrics Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
5
Division of Rheumatology, Allergy and Immunology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
6
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, Massachusetts, USA Division of Rheumatology, Allergy and Immunology, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Abstract

BACKGROUND:

Previous studies have suggested a potential risk of cervical cancer in patients with systemic inflammatory diseases (SID) such as inflammatory bowel disease (IBD) and systemic lupus erythematosus (SLE).

OBJECTIVES:

To assess the risk of high-grade cervical dysplasia, a surrogate endpoint for cervical cancer and cervical cancer, in women with SID, including IBD, psoriasis, rheumatoid arthritis (RA) or SLE, compared with the risk in women without SID.

METHODS:

Using US insurance data (2001-2012), we conducted a cohort study of 133,333 women with SID, based on two or more diagnoses and one or more dispensed prescription for disease-specific treatment, and 533,332 women without SID. High-grade cervical dysplasia and cervical cancer was defined by a validated algorithm with a positive predictive value of ≥81%.

RESULTS:

Over the mean follow-up of 2.1 years, the crude incidence rate of high-grade cervical dysplasia and cervical cancer per 100,000 person-years was the highest at 141.1 in SLE and the lowest at 82.2 in psoriasis among women with SID, and 73.4 in women without SID. The multivariable HR adjusted for potential confounders was 1.07 (95% CI 0.79 to 1.45) in IBD, 0.96 (95% CI 0.73 to 1.27) in psoriasis, 1.49 (95% CI 1.11 to 2.00) in RA and 1.53 (95% CI 1.07 to 2.19) in SLE. Multivariable HRs were increased, but not statistically significant, in IBD, RA and SLE with baseline use of systemic immunosuppressive drugs or steroids.

CONCLUSIONS:

The risk of high-grade cervical dysplasia and cervical cancer was 1.5 times higher in women with RA and SLE than in those without SID. The risk may be increased in IBD with use of systemic immunosuppressive drugs or steroids.

KEYWORDS:

Autoimmune Diseases; Epidemiology; Rheumatoid Arthritis; Systemic Lupus Erythematosus

PMID:
24618265
PMCID:
PMC4161656
DOI:
10.1136/annrheumdis-2013-204993
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center