Hutfless S, Fireman B, Kane S, Herrinton L J
Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA.
Aliment Pharmacol Ther. 2008 Sep 1;28(5):598-605. doi: 10.1111/j.1365-2036.2008.03766.x. Epub 2008 Jun 28.
Cervical cancer risk is high among immune suppressed women.
To evaluate inflammatory bowel disease (IBD) with medications and risk of cervical cancer.
Members of Kaiser Permanente Northern California (KPNC), 15-68 years from 1996 to 2006 with IBD were compared with age-matched women without IBD. Cervical cancer was ascertained using the KPNC Cancer Registry. IBD medications of interest were aminosalicylates (ASA), corticosteroids, immune modulators and infliximab. Odds of cervical cancer were analysed with adjusted logistic regression. The prevalence of Pap smear testing was compared using a log binomial model.
Ten cervical cancer cases occurred among 1165 women with IBD and 72 cancers among 12 124 controls. The adjusted odds ratio (OR) of IBD with risk of cervical cancer was 1.45 [95% confidence interval (CI) 0.74-2.84]. Medication ORs were 1.65 for ASA, 2.79 for corticosteroids and 3.45 for immune modulators (all P > 0.05). No cancer case used infliximab. The adjusted absolute increase in Pap smears among IBD women compared to women without IBD was 4% (95% CI 2-5%).
Although a trend of elevated risk for cervical cancer with IBD and IBD medications was observed, it was not statistically significant. Regular cervical cancer screening for women with IBD is recommended.
免疫抑制女性患宫颈癌的风险较高。
评估炎症性肠病（IBD）及其用药情况与患宫颈癌风险之间的关系。
将1996年至2006年期间年龄在15 - 68岁的北加利福尼亚凯撒医疗集团（KPNC）的炎症性肠病患者与年龄匹配的非炎症性肠病女性进行比较。通过KPNC癌症登记处确定宫颈癌病例。所关注的炎症性肠病药物包括氨基水杨酸类药物（ASA）、皮质类固醇、免疫调节剂和英夫利昔单抗。采用校正逻辑回归分析患宫颈癌的几率。使用对数二项模型比较巴氏涂片检查的患病率。
1165例炎症性肠病女性中有10例宫颈癌病例，12124例对照中有72例癌症病例。炎症性肠病患者患宫颈癌风险的校正比值比（OR）为1.45 [95%置信区间（CI）0.74 - 2.84]。氨基水杨酸类药物的用药OR为1.65，皮质类固醇为2.79，免疫调节剂为3.45（均P > 0.05）。没有癌症病例使用英夫利昔单抗。与非炎症性肠病女性相比，炎症性肠病女性巴氏涂片检查的校正绝对增加率为4%（95% CI 2 - 5%）。
尽管观察到炎症性肠病及其用药与患宫颈癌风险升高的趋势，但在统计学上并不显著。建议对炎症性肠病女性进行定期宫颈癌筛查。
