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Women with IBD may face higher cervical cancer risk
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A diagnosis of inflammatory bowel disease in women was found to be associated with increased risk for cervical neoplasia in a population-based nationwide cohort study.
“Our research shows that patients with IBD, specifically Crohn’s disease, are at increased risk for developing cervical cancer, even when undergoing the recommended screening,” Tine Jess, MD, from Statens Serum Institut in Denmark, said in a press release. “These findings provide an important reminder for IBD patients, and their physicians, to follow the recommended screening guidelines for cervical cancer.”
The study aimed to evaluate a Danish national cohort of female patients diagnosed with ulcerative colitis (n = 18,691) or CD (n = 8,717) from 1979 to 2011. The researchers individually matched the cohort to a large sample of women without IBD in the general population (n = 1,508,334) to examine the following:
- risk for cervical cancer and dysplasia in women diagnosed with IBD;
- effect of IBD medications on risk for cervical neoplasia;
- effect of hormonal contraceptive devices on risk for cervical neoplasia; and
- risk for cervical neoplasia before IBD diagnosis.
They found that participation in smear tests for cervical cancer screening was comparable between the general population and women with CD (incidence rate ratio [IRR] = 0.99; 95% CI, 0.96-1.02) and slightly higher in women with UC (IRR = 1.06; 95% CI, 1.04-1.08).
During a median follow-up of 7.8 years, 561 patients with UC were diagnosed with dysplasia (199 with low-grade squamous intraepithelial lesion [LSIL], 362 with high-grade [HSIL]), corresponding to a slightly increased risk for LSIL (IRR = 1.15; 95% CI, 1-1.32) and HSIL (IRR = 1.12; 95% CI, 1.01-1.25). Risk for developing cervical cancer was not significantly different from the general population.
During a median follow-up of 8.3 years, 407 patients with CD were diagnosed with dysplasia (145 with LSIL, 262 with HSIL), corresponding to a significantly increased risk for LSIL (IRR = 1.26; 95% CI, 1.07-1.48) and HSIL (IRR = 1.28; 95% CI, 1.13-1.45). Risk for developing cervical cancer was significantly higher compared with the general population (26 vs. 940 diagnoses; IRR = 1.53; 95% CI, 1.04-2.27).
Risk for cervical cancer 1 to 9 years before diagnosis of UC was higher compared with the general population (OR = 2.78; 95% CI, 2.12-3.64) and compared with the CD cohort (OR = 1.85; 95% CI, 1.08-3.15).
“Interestingly, reverse analyses showed markedly elevated odds of cervical neoplasia up to 10 years before IBD diagnosis, which may indicate a common susceptibility to cervical neoplasia and IBD,” the researchers concluded. “Patients with IBD should be encouraged to follow the screening program for cervical neoplasia, and clinicians should be aware of the slightly increased risk of HPV-related cervical lesions in IBD patients.” – by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.
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