Cervical cancer screenings important for young female patients with inflammatory bowel disease (IBD)

Women with inflammatory bowel disease (IBD) may be at increased risk of cervical dysplasia and cancer, according to a new study published in Clinical Gastroenterology and Hepatology (2015;13(4):693-700.e1).

Most often, IBD is considered to consist of two major diseases: ulcerative colitis and Crohn's disease. IBD affects men and women equally. The causes of IBD are not known, though several theories exist. Most frequently, IBD occurs in people in their late teens and 20s.

"Our research shows that patients with IBD, specifically Crohn's disease, are at increased risk for developing cervical cancer, even when undergoing the recommended screening," said study author Professor Tine Jess, MD, from Statens Serum Institut in Denmark.

"These findings provide an important reminder for IBD patients, and their physicians, to follow the recommended screening guidelines for cervical cancer."

Researchers conducted a population-based, case-controlled study of 27,408 women with IBD in Denmark, followed during a 35-year period. A total of 407 patients with Crohn's disease were diagnosed with dysplasia during a median follow-up of 8.3 years. Cervical cancer developed in 26 patients. The risk of low-grade and high-grade squamous intraepithelial lesions was increased in patients with ulcerative colitis or with Crohn's disease.

The study found a two-way association between IBD, notably Crohn's disease, and neoplastic lesions, or abnormal tissue growth, of the uterine cervix. This observation is not explained by differences in screening activity.

Although patients with both ulcerative colitis and Crohn's disease, which are the two most common forms of IBD, had higher odds of developing cervical cancer before IBD, only patients with Crohn's disease were at an increased risk of developing cervical cancer after the IBD diagnosis.

For patients with Crohn's disease, researchers found a significantly higher risk of cervical neoplasia diagnosed at a young age and in patients treated with azathioprine. Treatment with TNF-α antagonists and hormonal contraceptive devices may also influence risk of cervical neoplasia in Crohn's disease.

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