Abstract
Objective Women with systemic lupus erythematosus (SLE) are vulnerable to cervical dysplasia due to the persistence of human papillomavirus (HPV) infection. The objective of this cross-sectional retrospective study was to investigate the prevalence of cervical cancer screening per the American Society for Colposcopy and Cervical Pathology (ASCCP) SLE-specific cervical cancer screening guidelines. We also aimed to identify SLE-specific determinants associated with ASCCP adherence.
Methods Women aged 21-64 years enrolled in our institutional SLE registry were included in the study. The medical record was manually reviewed to determine whether the patient was up to date on screening and which organizational guideline was utilized, in addition to other clinical variables. Multivariable logistic regression was used to estimate adjusted odds ratios for ASCCP-congruent screening for each baseline characteristic.
Results 118 women were included in the study; 38% patients were up to date per ASCCP guidelines, 16% patients were up to date per non-ASCCP guidelines, and 46% of women were overdue for screening. Having a gynecologist and being actively treated with immunosuppressant therapies were both associated with an increased odds of being up to date per the ASCCP guidelines, while Hispanic ethnicity was associated with reduced odds.
Conclusion Only half of SLE women in our study had guideline-congruent cervical cancer screening. Current immunosuppression exposure, rather than SLE disease activity, was associated with an increased odds of being up to date by ASCCP guidelines. This study suggests the need for increased awareness and consensus among interdisciplinary providers regarding SLE-specific cervical cancer screening.
