Ladies with Lupus Skipping Paps

Systemic lupus erythematosus patients may not be getting recommended cervical cancer screening

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) For women under 30, yearly screening is one of the best ways to detect cervical cancer. Unfortunately, many women with lupus - a condition linked to cervical problems - may be skipping out on screening.

Women with lupus face a higher risk of cervical dysplasia and human papilloma virus (HPV) infection - two health problems that increase the risk of cervical cancer.

Cervical cancer screening can spot changes to the cervix well before cancer develops.

A recent study at a medical center showed that about one-third of women with lupus were not getting screened for cervical cancer. Overall, 75 percent of female patients at that medical center received cervical cancer screening within the past 3 years. In comparison, 66 percent of lupus patients were screened.

"Get regular Pap tests to detect cervical cancer."

According to Jennifer Stichman, MD, of the Denver Health Medical Center and the University of Colorado, and colleagues, few previous studies have looked at rates of cervical cancer screening in patients with lupus. In addition, these studies did not include uninsured and non-English speaking patients.

Dr. Stichman and colleagues set out to shed more light on this topic. They looked at rates of cervical cancer screening among women with lupus at Denver Health.

The researchers found that only 60 percent of lupus patients between 30 and 50 years of age had cervical cancer screenings in 3 years. In contrast, 81 percent of patients aged 21 to 29 underwent cancer screening.

The American College of Obstetrics and Gynecology recently updated its guidelines for cervical cancer screening. Women between 21 and 29 years of age should now be screened once every 3 years instead of once every 2 years. The guidelines recommend women aged 30 and older get tested with both a Pap test and HPV test only every 5 years. This co-testing is not recommended for women under 30.

Results from the study also showed that white lupus patients aged 21 to 29 years were less likely to get screened within 3 years than those who were not white.

In addition, women aged 21 to 29 years who had a history of gynecologic care (care of female reproductive system) were more likely to get screened at 1 and 3 years. Women aged 30 to 50 years were more likely to get screened at 1 and 3 years if they had seen a primary care doctor or had regular gynecologic care.

These findings suggest that patients with limited contact with doctors and specialists may be at risk of not being screened for cervical cancer.

According to the authors, rheumatologists (specialists in lupus, arthritis and other musculoskeletal and rheumatic conditions) need to help connect female lupus patients of all races with primary and gynecology care services.

The study involved 122 women with lupus. Of these, 80 percent (about 98 patients) were not white and half did not have health insurance.

The study's authors reported no conflicts of interest.

The research was presented at the American College of Rheumatology's annual meeting. As such, the study has yet to be reviewed by a body of peers for publication in a scientific journal. 

Reviewed by: 
Review Date: 
December 3, 2012
Last Updated:
February 25, 2013