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Increased risk of cervical dysplasia in females with autoimmune conditions—Results from an Australia database linkage study
BACKGROUND: Autoimmune conditions (AICs) and/or their treatment may alter risk of human papilloma virus (HPV) infection and females with AICs are therefore at an increased risk of cervical dysplasia. However, inclusion of these at-risk populations in cervical cancer screening and HPV-vaccination gui...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302686/ https://www.ncbi.nlm.nih.gov/pubmed/32555638 http://dx.doi.org/10.1371/journal.pone.0234813 |
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author | Foster, Emma Malloy, Michael J. Jokubaitis, Vilija G. Wrede, C. David H. Butzkueven, Helmut Sasadeusz, Joe Van Doornum, Sharon Macrae, Finlay Unglik, Gary Brotherton, Julia M. L. van der Walt, Anneke |
author_facet | Foster, Emma Malloy, Michael J. Jokubaitis, Vilija G. Wrede, C. David H. Butzkueven, Helmut Sasadeusz, Joe Van Doornum, Sharon Macrae, Finlay Unglik, Gary Brotherton, Julia M. L. van der Walt, Anneke |
author_sort | Foster, Emma |
collection | PubMed |
description | BACKGROUND: Autoimmune conditions (AICs) and/or their treatment may alter risk of human papilloma virus (HPV) infection and females with AICs are therefore at an increased risk of cervical dysplasia. However, inclusion of these at-risk populations in cervical cancer screening and HPV-vaccination guidelines, are mostly lacking. This study aimed to determine the prevalence of cervical dysplasia in a wide range of AICs and compare that to HIV and immunocompetent controls to support the optimisation of cervical cancer preventive health measures. METHODS: Data linkage was used to match cervical screening episodes to emergency department records of females with AICs or HIV to immunocompetent controls over a 14-year period. The primary outcome was histologically confirmed high-grade cervical disease. Results, measured as rates by cytology and histology classification per 1,000 females screened, were analysed per disease group, and intergroup comparisons were performed. RESULTS: Females with inflammatory bowel disease (2,683), psoriatic and enteropathic arthropathies (1,848), multiple sclerosis (MS) (1,426), rheumatoid arthritis (1,246), systemic lupus erythematosus and/or mixed connective tissue disease (SLE/MCTD) (702), HIV (44), and 985,383 immunocompetent controls were included. SLE/MCTD and HIV groups had greater rates of high-grade histological and cytological abnormalities compared to controls. Increased rates of low-grade cytological abnormalities were detected in all females with AICs, with the exception of the MS group. CONCLUSIONS: Females with SLE/MCTD or HIV have increased rates of high-grade cervical abnormalities. The increased low-grade dysplasia rate seen in most females with AICs is consistent with increased HPV infection. These findings support expansion of cervical cancer preventative programs to include these at-risk females. |
format | Online Article Text |
id | pubmed-7302686 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-73026862020-06-19 Increased risk of cervical dysplasia in females with autoimmune conditions—Results from an Australia database linkage study Foster, Emma Malloy, Michael J. Jokubaitis, Vilija G. Wrede, C. David H. Butzkueven, Helmut Sasadeusz, Joe Van Doornum, Sharon Macrae, Finlay Unglik, Gary Brotherton, Julia M. L. van der Walt, Anneke PLoS One Research Article BACKGROUND: Autoimmune conditions (AICs) and/or their treatment may alter risk of human papilloma virus (HPV) infection and females with AICs are therefore at an increased risk of cervical dysplasia. However, inclusion of these at-risk populations in cervical cancer screening and HPV-vaccination guidelines, are mostly lacking. This study aimed to determine the prevalence of cervical dysplasia in a wide range of AICs and compare that to HIV and immunocompetent controls to support the optimisation of cervical cancer preventive health measures. METHODS: Data linkage was used to match cervical screening episodes to emergency department records of females with AICs or HIV to immunocompetent controls over a 14-year period. The primary outcome was histologically confirmed high-grade cervical disease. Results, measured as rates by cytology and histology classification per 1,000 females screened, were analysed per disease group, and intergroup comparisons were performed. RESULTS: Females with inflammatory bowel disease (2,683), psoriatic and enteropathic arthropathies (1,848), multiple sclerosis (MS) (1,426), rheumatoid arthritis (1,246), systemic lupus erythematosus and/or mixed connective tissue disease (SLE/MCTD) (702), HIV (44), and 985,383 immunocompetent controls were included. SLE/MCTD and HIV groups had greater rates of high-grade histological and cytological abnormalities compared to controls. Increased rates of low-grade cytological abnormalities were detected in all females with AICs, with the exception of the MS group. CONCLUSIONS: Females with SLE/MCTD or HIV have increased rates of high-grade cervical abnormalities. The increased low-grade dysplasia rate seen in most females with AICs is consistent with increased HPV infection. These findings support expansion of cervical cancer preventative programs to include these at-risk females. Public Library of Science 2020-06-18 /pmc/articles/PMC7302686/ /pubmed/32555638 http://dx.doi.org/10.1371/journal.pone.0234813 Text en © 2020 Foster et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Foster, Emma Malloy, Michael J. Jokubaitis, Vilija G. Wrede, C. David H. Butzkueven, Helmut Sasadeusz, Joe Van Doornum, Sharon Macrae, Finlay Unglik, Gary Brotherton, Julia M. L. van der Walt, Anneke Increased risk of cervical dysplasia in females with autoimmune conditions—Results from an Australia database linkage study |
title | Increased risk of cervical dysplasia in females with autoimmune conditions—Results from an Australia database linkage study |
title_full | Increased risk of cervical dysplasia in females with autoimmune conditions—Results from an Australia database linkage study |
title_fullStr | Increased risk of cervical dysplasia in females with autoimmune conditions—Results from an Australia database linkage study |
title_full_unstemmed | Increased risk of cervical dysplasia in females with autoimmune conditions—Results from an Australia database linkage study |
title_short | Increased risk of cervical dysplasia in females with autoimmune conditions—Results from an Australia database linkage study |
title_sort | increased risk of cervical dysplasia in females with autoimmune conditions—results from an australia database linkage study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302686/ https://www.ncbi.nlm.nih.gov/pubmed/32555638 http://dx.doi.org/10.1371/journal.pone.0234813 |
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