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Original Article
DOI: 10.1016/j.reumae.2020.05.007
Available online 6 April 2021
Human papilloma virus screening: evaluation of testing and surveillance in rheumatoid arthritis, psoriatic arthritis and systemic lupus erythematosus
Cribado del virus de papiloma humano: evaluación de grado de vigilancia en artritis reumatoide, artritis psoriásica y lupus eritematoso sistémico
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Blanca Vidal Alejandrea, Ernesto Tovar Sugrañesb, Raquel López Pozaa, Mariano Andrésb, María Paz Martínez-Vidalb,
Corresponding author
mpmavidal@yahoo.es

Corresponding author.
a Facultad de Medicina, Universidad Miguel Hernández, Alicante, Spain
b Sección de Reumatología, Hospital General Universitario de Alicante, Alicante, Spain
Received 08 December 2019. Accepted 14 May 2020
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Tables (4)
Table 1. Positive results of screening (n = 13). The levels are expressed in absolutes and percentages, or as means and standard deviation.
Table 2. Association study for psoriatic arthritis (simple logistic regression).
Table 3. Association study for rheumatoid arthritis (simple logistic regression).
Table 4. Association study for systemic lupus erythematosus (simple logistic regression).
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Abstract
Background and objectives

Immunosuppression is a known risk factor for cervical cancer. Women with rheumatic conditions are immunosuppressed due to the disease and the treatments. One of the main risk factors for this neoplasm is the lack of adherence to early detection programmes for human papillomavirus. The objectives of this study were to evaluate the adherence to the screening programme of patients in the Rheumatology Clinic, as well as to evaluate the prevalence of cervical lesions and their association with the different disease characteristics and the treatments received.

Methods

A descriptive retrospective study. The electronic medical history of patients actively being followed up in a tertiary hospital with rheumatoid arthritis (RA), psoriatic arthritis (PSA) and systemic lupus erythematosus (SLE) were reviewed.

Results

Finally, 307 patients were included. No data were found for screening programme attendance in up to 42.4% of the patients (39.6% in RA, 43.8% in PSA and 46% in SLE). Among the patients who attended the screening programme at least once (57.6%), the prevalence of cervical dysplasia was 5.1%. No cases of neoplasia were found. In the simple logistic regression analysis, there was no association between attending the screening programme and any variable. The study also showed no association between the variables collected and the presence of infection and dysplasia.

Conclusion

These results are influenced by the absence of screening data in a significant percentage of patients and by the low prevalence of dysplasia found in this series of patients with rheumatic diseases.

Keywords:
Rheumatoid arthritis
Psoriatic arthritis
Systemic lupus erythematosus
Screening
Dysplasia
Cervical neoplasia
Resumen
Introducción y objetivos

Las pacientes con enfermedades reumatológicas presentan un estado de inmunosupresión por la enfermedad de base y los tratamientos utilizados, lo cual es un factor de riesgo para desarrollar neoplasia de cérvix uterino. Uno de los principales factores de riesgo consiste en no acudir al programa de detección precoz del virus del papiloma humano. Los objetivos de este trabajo fueron evaluar la adherencia al programa de cribado de pacientes seguidas en consultas externas de reumatología, así como estudiar la prevalencia de lesiones cervicales y su asociación con distintos aspectos de la enfermedad y los tratamientos recibidos.

Material y métodos

Estudio retrospectivo en el que se revisaron las historias clínicas electrónicas de pacientes con seguimiento activo en un hospital terciario con artritis reumatoide (AR), artritis psoriásica (APS) y lupus eritematoso sistémico (LES).

Resultados

Se incluyó 307 pacientes. No se hallaron datos de asistencia al cribado en 42,4% (39,6% en AR, 43,8% en APS y 46% en LES). Entre las pacientes que asistieron al menos una vez (57,6%), la prevalencia de displasia de cérvix fue del 5,1%. No se encontró ningún caso de neoplasia. En el análisis de regresión logística simple no se encontró asociación entre las variables recogidas y la presencia de infección y displasia.

Conclusión

Es remarcable la ausencia de datos de asistencia al cribado de cáncer de cérvix en un porcentaje considerable de las pacientes con enfermedades reumáticas, lo cual dificulta el estudio del papel de la enfermedad y su tratamiento.

Palabras clave:
Artritis reumatoide
Artritis psoriásica
Lupus eritematoso sistémico
Cribado
Displasia
Neoplasia de cérvix

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