Improving Human Papillomavirus-Related Cervical Cancer Screening in Patients With Systemic Lupus Erythematosus

Tiphaine Goulenok; Céline Mendes; Léa Dayan; Valentine Marie Ferre; Margot Bucau; Fatima Farhi; Thomas Papo; Karim Sacré

doi:10.3899/jrheum.2022-1335

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Table.

Characteristics of patients with SLE at baseline.

	Up to Date, n = 76	Not Up to Date, n = 66	P
Sociodemographics
Age, yrs, median (IQR)	43.0 (37.7-50.0)	43.0 (33.0-51.0)	0.47
Healthcare insurance	58 (76)	49 (74)	0.85
Profession
Senior executive	11 (14)	8 (12)	0.81
Intermediate occupation	30 (39)	12 (18)	0.01
Employee/worker	8 (10)	2 (3)	0.11
Student	0 (0)	2 (3)	0.21
Retired	1 (1)	0 (0)	> 0.99
Unemployed	14 (18)	26 (39)	0.01
SLE disease characteristics^{^a}
SLE duration, yrs, median (IQR)	12.0 (5.0-22.0)	8.5 (4.0-16.2)	0.12
Arthritis	55 (72)	45 (68)	0.71
Skin lesions	48 (63)	40 (61)	0.86
Class III/IV/V LN	30 (39)	25 (38)	0.86
SLEDAI, median (IQR)	2 (0-4)	2 (0-4)	0.85
Current prescription of HCQ	67 (82)	60 (91)	0.78
Current prescription of steroids	39 (51)	29 (44)	0.40
Current prescription of IS drugs	23 (30)	17 (26)	0.58
Sexual and behavior risk factors
Lifetime sexual partners, median (IQR)	2.5 (1.0-4.0)	3.0 (1.0-5.0)	0.63
Age at sexual debut, yrs, median (IQR)	19.0 (17.0-22.5)	19.0 (17.5-20.5)	0.99
Previous STD	5 (7)	1 (1)	0.22
Previous/current use of hormonal contraception	48 (63)	34 (51)	0.18
HPV vaccine	3 (4)	1 (1)	0.62
Ever/current smoking	14 (18)	10 (15)	0.66
Multiparity	30 (39)	19 (29)	0.22
Knowledge about CCS
CCS is performed for the diagnosis of:
Infection	47 (62)	30 (45)	0.06
Malignancy	51 (67)	39 (59)	0.38
SLE-specific features	5 (7)	12 (18)	0.04
Reasons for not being up to date for CCS
Not knowing my GPs could perform CCS	–	24 (36)	–
Not knowing CCS should be repeated, even when normal at first	–	20 (30)	–
CCS is unpleasant/painful	–	19 (29)	–
Postponed	–	17 (26)	–
Cannot get a gynecologist where I live	–	14 (21)	–
Not being advised by my GP/specialist to have CCS	–	12 (18)	–
No reason because no hormonal contraception	–	10 (15)	–
Too many physicians’ appointments		8 (12)
No reason because no sexual relationship	–	6 (9)	–
Cost	–	5 (8)	–
Not feeling able to send sample to a laboratory for analysis	–	2 (3)	–

Values are expressed as n (%) unless indicated otherwise.
↵^a The median time delay between SLE disease assessment and CCS in patients who were not up to date at baseline was 2.5 (range 0.5-8.0) months. CCS: cervical cancer screening; GP: general practitioner; HCQ: hydroxychloroquine; HPV: human papillomavirus; IS: immunosuppressive; LN: lupus nephritis; SLE: systemic lupus erythematosus; SLEDAI: Systemic Lupus Erythematosus Disease Activity Index; STD: sexually transmitted disease.