Cervical Cancer Risk (CCFA 2007)
I am posting this blog from south Florida, site of the 2007 national meeting of the Crohn’s and Colitis Foundation. Several provocative presentations have been made, some of which I will summarize over the next several days.
Researchers from Johns Hopkins, the Mayo Clinic, and Kaiser Permanente (Hutfless S, et al) studied the risk of cervical cancer in patients with inflammatory bowel disease (IBD). Using a large database including 30% of the population in the San Francisco Bay area the authors identified eight cases of cervical cancer out of 1841 patients with IBD and a pap smear. The risk of cervical cancer in IBD patients was 1.7 times greater than in healthy controls, but this difference was not quite statistically significant. When the results were broken down by medication, there was no increased risk of cervical cancer in patients taking corticosteroids, immune modulators (methotrexate or azathioprine), or 5-aminosalicylates, while patients on infliximab had an eleven-fold increase in risk.
An even larger study would be required to better determine the risk of cervical cancer in various treatment groups. Fortunately, the pap smear is an effective screening test for cervical cancer and all IBD patients, especially those on infliximab should have appropriate and regular screening. Furthermore, girls and young women with IBD should receive the HPV vaccine to reduce their risk of cervical cancer.