High Disease Activity Linked to Lower Cervical Cancer Screening Rates in Women with SLE, Study Finds

The study, published in Arthritis Care & Research, revealed that women with SLE who experience high disease activity are less likely to undergo cervical cancer screening compared to those with lower disease activity. Additionally, perceived barriers to screening are moderately associated with reduced screening rates.

"These findings underscore the importance of developing targeted strategies to enhance cervical cancer screening in this high-risk group," the researchers wrote. 

Systemic lupus erythematosus is a chronic autoimmune disease that can significantly impact overall health and complicate the management of other medical conditions. Women with SLE are at an increased risk for several health issues, including cervical cancer, making regular screening essential. Sebastian Bruera, Baylor College of Medicine, Houston, Texas, and colleagues aimed to determine cervical cancer screening rates and factors associated with reduced cervical cancer screening in women with SLE.

For this purpose, the researchers conducted a cross-sectional study involving consecutive women aged 21 to 64 with SLE. They gathered data on demographics, clinical characteristics, and Health Beliefs Model (HBM) components, including susceptibility, severity, barriers, benefits, cues to action, and self-efficacy. Self-reported cervical cancer screening data, which were verified with electronic medical records, were also collected.

The primary outcome was adherence to cervical cancer screening as per current guidelines. Multivariable logistic regression models were employed to analyze the relationship between SLE disease activity and cervical cancer screening and to explore the mediation effects of HBM constructs.

The following were the key findings of the study:

• One hundred thirty women with SLE were enrolled. The median age was 42 years.
• The cervical cancer screening adherence rate was 61.5%.
• Women with high SLE disease activity were less likely to have cervical cancer screening versus those with low disease activity (odds ratio 0.59), which remained statistically significant after adjusting for baseline demographics and drug therapy in a multivariable model (odds ratio 0.25).
• Regarding the HBM constructs, increased perceived barriers to cervical cancer screening (r = −0.30) and decreased self-efficacy (r = −0.21) correlated with decreased cervical cancer screening.

The findings reveal that women with high disease activity are less likely to undergo cervical cancer screening compared to those with lower disease activity.

In summary, the study sheds light on the factors influencing cervical cancer screening adherence among women with systemic lupus erythematosus and calls for targeted interventions to improve screening rates in this high-risk group.

Reference:

Bruera, S., Bowman, S., Huang, Y., Suarez-Almazor, M. E., Lo, G. H., Lopez-Olivo, M., Chiao, E., Kramer, J. R., Pereira, F. A., & Agarwal, S. K. (2024). Factors Associated With Adherence of Cervical Cancer Screening in Women With Systemic Lupus Erythematosus. Arthritis Care & Research, 76(9), 1224-1231. https://doi.org/10.1002/acr.25355