Rheumatology Advance Access originally published online on July 27, 2004
Rheumatology 2004 43(11):1386-1389; doi:10.1093/rheumatology/keh331
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Rheumatology Vol. 43 No. 11 © British Society for Rheumatology 2004; all rights reserved
PAPER |
Factors associated with abnormal Pap results in systemic lupus erythematosus
Division of Clinical Epidemiology, Montreal General Hospital, Canada, 1 Division of Rheumatology, Northwestern University, Chicago, USA, 2 Department of Rheumatology, University of Birmingham, UK, 3 Department of Epidemiology and Biostatistics, McGill University, 4 Department of Oncology and 5 Division of Clinical Immunology/Allergy, Montreal General Hospital, Montreal, Canada.
Correspondence to: S. Bernatsky, 1650 Cedar Ave., Room L10-520, Montreal, Quebec, H3G 1A4, Canada.
Objective. Previous studies have suggested that women with systemic lupus erythematosus (SLE) are at greater risk for cervical dysplasia than are women in the general population. However, the factors associated with abnormal Pap test results in SLE have not been well studied. We therefore aimed to determine the factors associated with lifetime occurrence of an abnormal Pap test in women with SLE, and the influence of immunosuppressive exposure on the odds of abnormal Pap test results occurring after diagnosis of SLE.
Methods. Data were pooled from SLE cohorts from three centres. Self-report data were available on smoking, reproductive history, use of oral contraceptives (OC), history of sexually transmitted diseases (STDs) and whether the subjects had had cervical dysplasia on Pap testing. Logistic regression was used to examine the effect of these variables on the lifetime odds of cervical dysplasia. We then generated the adjusted odds ratio (OR) for the effect of immunosuppressive exposure on cervical dysplasia occurring after diagnosis of SLE.
Results. History of STDs and use of OCs were positively associated with reports of cervical dysplasia in adjusted analyses. The ORs for the effect of immunosuppressives on abnormal Pap test occurrence (adjusted for race, age, smoking, nulliparity, OC use and history of STDs) after diagnosis of SLE was 1.6 (95% CI 1.0, 2.7).
Conclusions. A history of STDs and use of OCs were associated with abnormal Pap reports in this SLE sample. Immunosuppressive exposure may confer further risk to women with SLE.
KEY WORDS: Systemic lupus erythematosus, Cervical dysplasia, Pap test
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