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Poster presentations: Epidemiology 2020

P756 Cervical smear screening results amongst women with inflammatory bowel disease at an Irish hospital

L. Pillay, R.S. Piggott, N. Ganter, G. McCormack

Midlands Regional Hospital Tullamore, Department of Gastroenterology, Tullamore, Ireland

Background

Human papillomavirus (HPV) is strongly linked to the pathogenesis of cervical dysplasia; women with IBD may be at greater risk of developing cervical pathology, especially those on immunosuppressive therapies. In Ireland a national screening programme begins at age 25 and continues until age 60. This was a preliminary study looking at the number of women seen at our IBD clinic with a prior abnormal smear test, and the correlation to their medication history.

Methods

All women attending our IBD service, over an 8 week duration, were asked to complete a questionnaire regarding previous smear testing and results. We also looked at their diagnosis, years since diagnosis and medication history. Any patient who was referred on for a colposcopy was considered as having an abnormal smear.

Results

A total of 80 women with an average age of 51.5 years (SD ±±33.5) and with an average 20.8 years (SD ±±20.2) since diagnosis had been screened. 10 were under the age of 25 and thus excluded, of these 7 were vaccinated against HPV. Seven women who were eligible, had never had a smear and therefore excluded. A total of 63 women previously had a smear test in their lifetime.

Table 1. Results of smear testing amongst our patients

Total number who have had a previous smear in their lifetime (n)63
Total number whose last smear was normal61 (97%)
Total number whose last smear was abnormal2 (3%)
Total number who have had an abnormal smear in their lifetime15 (23.8%)

Table 2. Relation between abnormal smear test and previous drug exposure

Total number who have had a previous abnormal smear15
No Previous Immunosuppression3 (20%)
Previous exposure to a Biologic ONLY10 (66%)
Previous exposure to an immunomodulator ONLY2 (13%)
Previous exposure to BOTH a biologic and an immunomodulator5 (33%)
Previous Exposure to Biologic or Azathioprine12 (80%)P <0.001

Conclusion

Conclusion Our study shows that women in our IBD cohort have a significantly higher risk of having an abnormal smear vs. the average Irish women (23.8% vs. national average of 9.8%, p = 0.006). Furthermore, the majority (80%, p < 0.001) of these patients were on immunosuppressive therapy at the time of the abnormal smear test. While the conclusion we can draw from this study are limited, we believe it emphasises the need for stringent adherence by IBD patients to screening guidelines for early detection of cervical dysplasia.