Video Abstract: Increased Risk of Cervical Cancer in Women with IBD

Women with ulcerative colitis or Crohn’s disease are at increased risk for cervical neoplasias, researchers report in the April issue of Clinical Gastroenterology and Hepatology.

Christine Rungoe et al performed a population-based cohort study of 27,408 women with inflammatory bowel diseases (IBD).

In her video abstract, she says “we observed that women with ulcerative colitis had an increased risk of high-grade dysplasia vs controls. Women with Crohn’s disease had increased risk of low- and high-grade dysplasia and invasive cervial cancer.”

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Women with Crohn’s disease underwent cervical cancer screening as often as women in the general population, whereas women with ulcerative colitis were screened at slightly higher-than-normal frequencies.

Common medications for IBD do not appear to affect the risk of cervical neoplasia risk in women with ulcerative colitis. But women with Crohn’s disease who received anti-tumor necrosis factor therapy (azathioprine) have a significant increase in risk of high-grade squamous intraepithelial lesions, compared with non-users.

The authors say they found a significantly higher risk of cervical neoplasia in patients diagnosed with Crohn’s disease at young age or treated with azathioprine. They did not find that use of mesalamine or corticosteroids affected the risk of cervical dysplasia.

Rungoe et al also found that women with Crohn’s disease had a 2% increase in risk for high-grade squamous intraepithelial lesions per redeemed prescription of hormonal contraceptives.

In reverse analyses, Rungoe says they observed an” increased odds of cervical cancer and high-grade dysplasia up to 9 years before diagnoses of ulcerative colitis or Crohn’s disease, compared to subjects without IBD.”

The authors state that patients with IBD should follow screening programs for cervical and other cancers. Clinicians should be aware of these women’s slight increase in risk of cervical lesions.

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