Screening differences and risk of cervical cancer in inflammatory bowel disease
Article first published online: 28 JUN 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 28, Issue 5, pages 598–605, September 2008
How to Cite
HUTFLESS, S., FIREMAN, B., KANE, S. and HERRINTON, L. J. (2008), Screening differences and risk of cervical cancer in inflammatory bowel disease. Alimentary Pharmacology & Therapeutics, 28: 598–605. doi: 10.1111/j.1365-2036.2008.03766.x
- Issue published online: 31 JUL 2008
- Article first published online: 28 JUN 2008
- Publication data Submitted 5 May 2008 First decision 29 May 2008 Resubmitted 9 June 2008 Accepted 10 June 2008 Epub Accepted Article 28 June 2008
Background Cervical cancer risk is high among immune suppressed women.
Aim To evaluate inflammatory bowel disease (IBD) with medications and risk of cervical cancer.
Methods Members of Kaiser Permanente Northern California (KPNC), 15–68 years from 1996 to 2006 with IBD were compared with age-matched women without IBD. Cervical cancer was ascertained using the KPNC Cancer Registry. IBD medications of interest were aminosalicylates (ASA), corticosteroids, immune modulators and infliximab. Odds of cervical cancer were analysed with adjusted logistic regression. The prevalence of Pap smear testing was compared using a log binomial model.
Results Ten cervical cancer cases occurred among 1165 women with IBD and 72 cancers among 12 124 controls. The adjusted odds ratio (OR) of IBD with risk of cervical cancer was 1.45 [95% confidence interval (CI) 0.74–2.84]. Medication ORs were 1.65 for ASA, 2.79 for corticosteroids and 3.45 for immune modulators (all P > 0.05). No cancer case used infliximab. The adjusted absolute increase in Pap smears among IBD women compared to women without IBD was 4% (95% CI 2–5%).
Conclusions Although a trend of elevated risk for cervical cancer with IBD and IBD medications was observed, it was not statistically significant. Regular cervical cancer screening for women with IBD is recommended.