Factors associated with abnormal Pap results in systemic lupus erythematosus.
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.
Division of Clinical Epidemiology, Montreal General Hospital, Quebec, Canada.
S
S
Bernatsky
R
R
Ramsey-Goldman
C
C
Gordon
L
L
Joseph
J-F
JF
Boivin
R
R
Rajan
A
A
Allen
A D
AD
Moore
M-H
MH
Leung
A
A
Clarke
D000328:Adult; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D002578:Uterine Cervical Dysplasia / Q000209:etiology*; D014626:Vaginal Smears
D007166:Immunosuppressive Agents