Immunosuppression results in a higher incidence of cervical dysplasia compared with healthy controls.
Dr Sunanda Kane and colleagues from the USA examined the relationship between immunomodulator use, and the presence of abnormal cervical histology in women with inflammatory bowel disease (IBD).
The team recruited women with inflammatory bowel disease, and serial pap smears.
|The incidence of any abnormal pap in a woman with IBD was 43%|
|American Journal of Gastroenterology|
Patients were compared to age-, race-, and parity-matched controls.
Pap smears were recorded in relation to exposure to immunomodulators.
Variables included diagnosis, type, and duration of immunosuppressant, and smoking.
The researchers included 40 patients with 134 pap smears.
The incidence of any abnormal pap in a woman with inflammatory bowel disease was 43% versus 7% of controls.
The team found that women with inflammatory bowel disease were more likely to have higher-grade lesions than controls.
Those women with a history of exposure to immunosuppression were more likely to have an abnormal Pap smear than controls.
The team of doctors noted that pap smears done with over 6 months exposure to an immunosuppressant resulted in increased risk..
Cytopathology of abnormal lesions revealed either HPV serotype 16 or 18 in all specimens.
Multivariate analysis did not reveal any differences between the groups when controlled for other variables.
Dr Kanes' team concluded, "Women with inflammatory bowel disease have a higher risk of an abnormal pap smear compared with healthy controls."
"Patients with immunomodulator use have a higher risk of an abnormal pap smear associated with HPV infection."
"Women with inflammatory bowel disease should be included in the American College of Obstetrics and Gynecology screening guidelines for immunocompromised individuals."