Reports of abnormal cervical cancer screening tests in systemic sclerosis

Rheumatology (Oxford). 2009 Feb;48(2):149-51. doi: 10.1093/rheumatology/ken442. Epub 2008 Dec 15.

Abstract

Objective: To assess the prevalence of abnormal cervical cancer screening (Pap tests) reported by women with SSc onset before the age of 50 yrs.

Methods: Female members of a Canadian multi-centre SSc cohort completed standardized assessments and were questioned regarding a history of an abnormal Pap test. Potential correlates examined included demographics, reproductive history, smoking, diffuse vs limited SSc type, immunosuppressant exposure and SSc duration.

Results: In the 320 women with SSc onset before the age of 50 yrs, the life-time prevalence of an abnormal Pap test (according to self-report) was 25.4% (95% CI CI 20.9, 30.4%). By comparison, self-reported prevalence of abnormal Pap tests among general population Canadian females was recently reported at 13.8% (95% CI 11.6, 16.4%). Women with diffuse SSc (n = 142), tended to have a higher prevalence of self-reported cervical dysplasia (31.7%) compared with those with limited disease (20.7%), but the CIs overlapped. A multivariate logistic regression found a significant positive association between self-reported abnormal Pap test and diffuse disease [odds ratio (OR) 1.87; 95% CI 1.01, 3.47]. An independent association of an abnormal Pap test with smoking (OR 2.43; 95% CI 1.23, 4.78) and with younger age at disease onset was also noted.

Conclusions: We noted a high prevalence of abnormal Pap tests self-reported in our sample. Increased risk was seen among those with diffuse SSc, and also among smokers and those with a younger age at disease onset. Thus, it seems prudent to ensure that adequate attention is paid to cervical cancer screening for women with SSc.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age of Onset
  • Cohort Studies
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Logistic Models
  • Odds Ratio
  • Risk Factors
  • Scleroderma, Systemic / complications*
  • Scleroderma, Systemic / drug therapy
  • Smoking / adverse effects
  • Uterine Cervical Neoplasms / complications*
  • Uterine Cervical Neoplasms / diagnosis*
  • Vaginal Smears*

Substances

  • Immunosuppressive Agents