Women with inflammatory bowel diseases have a suboptimal cervical cancer screening rate and are not aware of the recommended human papilloma virus vaccine

Abstract

The aim of the study was to assess the self-reported cervical cancer screening rate among patients with inflammatory bowel diseases (IBD) and patient attitude towards human papilloma virus (HPV) vaccination. A self-designed survey was conducted in hospitalized IBD patients. The survey comprised demographic data, questions regarding cervical smear test frequency and vaccinations recommended for an IBD patient. Randomly, patients completed the survey with a physician present to determine question comprehension. In order to provide test-retest reliability a group of 10 patients completed it twice. Survey data from 150 IBD patients (mean age: 36 years, SD ± 13; mean IBD duration: 10 years, SD ± 6.5) were analyzed. Fifteen percent of the patients reported irregular cervical testing and 15% do not remember when having had a previous cervical testing performed. Only 69% of the patients undergo testing regularly; 30% annually, 32% every 2-3 years; 7% every 5 years. The mean age of patients tested regularly was 22 years, vs. 32 years tested irregularly (p < .001). Only 10% of women claimed that HPV vaccine is recommended for an IBD patient. There is a low adherence to the recommendations regarding cervical cancer screening and prophylaxis. Better multi-disciplinary cooperation between patients and physicians is required to improve patient education and outcomes.

Vulvar and vaginal neoplasia in women with inflammatory bowel disease

“…Currently it is unclear whether the same effect can be expected in IBD patients, with or without immunosuppressive therapy. Regardless of a general awareness among gastroenterologists of an elevated risk of HPV-related neoplasia in IBD, screening for cervical cancer and HPV-vaccination in female IBD patients is still suboptimal [34].…”

Vaccination in Patients with Inflammatory Bowel Diseases

“…A study by Long et al [54] revealed that only 70.4% of female IBD patients received cervical testing at least once every 3 years. In a recent study by Waszczuk et al [55], among 150 female IBD patients, only 69% reported of regular cervical testing (30% annually, 32% every 2-3 years, 7% every 5 years). Moreover, only 10% of female IBD patients were aware of the existing HPV vaccination recommendation.…”

Inflammatory bowel disease and women’s sexual and reproductive health: a narrative review

“…Women who are immunocompromised, as in IBD, have an increased risk of cervical dysplasia and cancer. 4 In a study involving 40 patients with IBD the incidence of abnormal smear was 42.5% versus 7% of controls. Women with IBD, women undergoing immunosuppressive treatment, or history of their use, have also a higher incidence of high-grade lesions in pap smear.…”

“…This study shows the importance of physicians cooperation in patient surveillance. 4 American College of Obstetrics and Gynaecology (ACOG) also recommends annual screening in resemblance to woman HIV positive. 6 However, a medical history of human papillomavirus (HPV) infection is not a formal indication for the suspension of immunosuppressive treatment.…”

“…The vaccine showed good tolerance and immunologic response in women between 9 and 26 years old under biological medications, similar to healthy controls. 4,5…”