Human papilloma virus screening: evaluation of testing and surveillance in rheumatoid arthritis, psoriatic arthritis and systemic lupus erythematosus

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. 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. 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. 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. 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. 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). Se incluyó 307 pacientes. No se hallaron datos de asistencia al c