Increased Risk of High-grade Cervical Neoplasia in Women with Inflammatory Bowel Disease: A Case-controlled Cohort Study.

Autor: Goetgebuer RL; Erasmus MC, University Medical Center, Gastroenterology and Hepatology, Rotterdam, The Netherlands., Kreijne JE; Erasmus MC, University Medical Center, Gastroenterology and Hepatology, Rotterdam, The Netherlands., Aitken CA; Erasmus MC, University Medical Center, Public Health, Rotterdam, The Netherlands., Dijkstra G; University Medical Center Groningen, Gastroenterology and Hepatology, Groningen, The Netherlands., Hoentjen F; Radboud University Medical Center, Gastroenterology and Hepatology, Nijmegen, The Netherlands., de Boer NK; Department of Gastroenterology and Hepatology, AG&M Research Institute, Amsterdam University Medical Centre, Amsterdam, The Netherlands., Oldenburg B; University Medical Center Utrecht, Gastroenterology and Hepatology, Utrecht, The Netherlands., van der Meulen AE; Leiden University Medical Center, Gastroenterology and Hepatology, Leiden, The Netherlands., Ponsioen CIJ; Academic Medical Center, Gastroenterology and Hepatology, Amsterdam, the Netherlands., Pierik MJ; Maastricht University Medical Center, Gastroenterology and Hepatology, Maastricht, The Netherlands., van Kemenade FJ; Erasmus MC, University Medical Center, Pathology, Rotterdam, The Netherlands., de Kok IMCM; Erasmus MC, University Medical Center, Public Health, Rotterdam, The Netherlands., Siebers AG; PALGA, The Nationwide Network and Registry of Histo- and Cytopathology in The Netherlands, Houten, The Netherlands.; Radboud University Medical Center, Pathology, Nijmegen, The Netherlands., Manniën J; Leiden University Medical Center, Biomedical Data Sciences, Leiden, The Netherlands., van der Woude CJ; Erasmus MC, University Medical Center, Gastroenterology and Hepatology, Rotterdam, The Netherlands., de Vries AC; Erasmus MC, University Medical Center, Gastroenterology and Hepatology, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Journal of Crohn's & colitis [J Crohns Colitis] 2021 Sep 25; Vol. 15 (9), pp. 1464-1473.
DOI: 10.1093/ecco-jcc/jjab036
Abstrakt: Background and Aims: Women with inflammatory bowel disease [IBD] may be at higher risk for cervical intraepithelial neoplasia [CIN]. However, data are conflicting. The aim of this study was to assess the risk of high-grade dysplasia and cancer [CIN2+] in IBD women and identify risk factors.
Methods: Clinical data from adult IBD women in a multicentre Dutch IBD prospective cohort [PSI] from 2007 onwards were linked to cervical cytology and histology records from the Dutch nationwide cytology and pathology database [PALGA], from 2000 to 2016. Patients were frequency-matched 1:4 to a general population cohort. Standardised detection rates [SDR] were calculated for CIN2+. Longitudinal data were assessed to calculate CIN2+ risk during follow-up using incidence rate ratios [IRR] and risk factors were identified in multivariable analysis.
Results: Cervical records were available from 2098 IBD women [77%] and 8379 in the matched cohort; median follow-up was 13 years. CIN2+ detection rate was higher in the IBD cohort than in the matched cohort (SDR 1.27, 95% confidence interval [CI] 1.05-1.52). Women with IBD had an increased risk of CIN2+ [IRR 1.66, 95% CI 1.21-2.25] and persistent or recurrent CIN during follow-up (odds ratio [OR] 1.89, 95% CI 1.06-3.38). Risk factors for CIN2+ in IBD women were smoking and disease location (ileocolonic [L3] or upper gastrointestinal [GI] [L4]). CIN2+ risk was not associated with exposure to immunosuppressants.
Conclusions: Women with IBD are at increased risk for CIN2+ lesions. These results underline the importance of human papillomavirus [HPV] vaccination and adherence to cervical cancer screening guidelines in IBD women, regardless of exposure to immunosuppressants.
(© The Author(s) 2021. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation.)
Databáze: MEDLINE
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