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Risk of high-grade cervical dysplasia and cervical cancer in women with systemic inflammatory diseases: a population-based cohort study.
- Source :
-
Annals of the rheumatic diseases [Ann Rheum Dis] 2015 Jul; Vol. 74 (7), pp. 1360-7. Date of Electronic Publication: 2014 Mar 11. - Publication Year :
- 2015
-
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).<br />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.<br />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%.<br />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.<br />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.<br /> (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)
- Subjects :
- Adult
Algorithms
Case-Control Studies
Cohort Studies
Female
Follow-Up Studies
Humans
Incidence
Middle Aged
Retrospective Studies
Risk Factors
Inflammatory Bowel Diseases complications
Lupus Erythematosus, Systemic complications
Uterine Cervical Dysplasia epidemiology
Uterine Cervical Neoplasms epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1468-2060
- Volume :
- 74
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Annals of the rheumatic diseases
- Publication Type :
- Academic Journal
- Accession number :
- 24618265
- Full Text :
- https://doi.org/10.1136/annrheumdis-2013-204993