Cervical screening attendance and results for women with rheumatoid arthritis in England

What is it about?

Rheumatoid arthritis (RA) and the treatments we use for RA, particularly biological therapies, can alter the function of your immune system. Abnormal cervical smears are closely linked to herpes simplex virus (HSV); women with an abnormal immune system are at higher risk of contracting HSV and therefore could be at higher risk of cervical smear abnormalities. Moreover, disability associated with RA could impact on women’s ability to attend for cervical screening. Studies in the United States and Sweden suggested that women with RA are attending cervical screening as frequently as women without RA, but that they are at higher risk of developing severe cervical smear abnormalities than women in the general population. The British Society for Rheumatology Biologics Register for RA (BSRBR-RA) collects information on people with RA starting biologic therapy alongside a smaller comparison group of patients on non-biologic therapy. Between 2001 and 2015, 12,785 women with RA had consented to participate in the register and also had cervical screening data available to access via linkage to the Cervical Screening Programme England. Overall attendance for cervical screening was higher in women in the BSRBR-RA than in the general population, especially for women aged 25-49 years. However, overall screening attendance for women in the BSRBR-RA was 78% for women reporting high levels of physical disability in comparison to 85% for women reporting lower levels of physical disability. We found no evidence supporting an increased risk of severe cervical smear abnormalities in women with RA compared to the general population in England, but this may be related to the higher screening attendance in this group.

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Photo by Online Marketing on Unsplash

Photo by Online Marketing on Unsplash

Why is it important?

This study supports the importance of attending routine cervical screening, and that we need to continue to encourage women with RA to attend cervical screening appointments, particularly women reporting higher levels of physical disability.

Perspectives