Systemic lupus erythematosus increases risk for cervical neoplasia

LONDON — Women with systemic lupus erythematosus, or SLE, are at a greater risk for cervical neoplasia, especially those treated with immunosuppressive drugs, according to a speaker here at the EULAR Annual Congress.

“Women with SLE appear to be at increased risk for cervical neoplasia. It is more pronounced for premalignant and invasive cancers,” Johan Askling, MD, PhD, from the department of medicine at Karolinska Institutet in Stockholm, Sweden, said during a press conference. “Treatment with SLE is a marker of further increasing the risk. In fact, it contains the overall increase for invasive cancers, but whether this is due to drugs or the indication, we do not really know.”

Askling and colleagues identified 4,450 women with SLE from Swedish registries and 28,113 matched controls from the general population. The Swedish National Cervical Screening Registry was used to collect data on cervical screenings. Patients were further divided by whether they used antimalarial drugs (n = 1,783) or other immunosuppressive treatments (n = 1,981), as defined by the Swedish Prescribed Drug Register.

Johan Askling

At follow-up, the Swedish National Cervical Screening Registry and Swedish Cancer Registry were used to determine outcomes of cervical dysplasia and invasive cervical cancer. Other outcomes assessed separately included cervical intraepithelial neoplasia grades 1 and 2/3, and invasive malignancy. Askling and colleagues used Cox models to estimate hazard ratios.

Investigators found women with SLE had a doubled rate for cervical dysplasia or invasive cancer compared with the general population. Women treated with systemic immunosuppressive drugs vs. those treated with antimalarial drugs had a higher rate for cancer. Immunosuppressives were correlated with a higher chance of cervical dysplasia or neoplasms compared with women treated with antimalarials.

“Women with SLE should be screened for cervical cancer, and if there is a population-based screening program … [it] is particularly good to adhere to that program,” Askling said. “We do not think, at this stage, additional measures should be taken.” – by Monica Jaramillo

Reference:

Wadström H, et al. Abstract #OP0189. Presented at: EULAR Annual Congress; June 8-11, 2016; London.

Disclosure: Askling reports no relevant financial disclosures.