Abnormal Pap smears common in women with lupus

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Women with systemic lupus erythematosus (SLE) are more likely to have an abnormal Pap test result than other women, according to a new report. This is important because abnormal smears can be associated with cervical cancer.

“From the results of our...study, I would recommend cervical screening at least once a year for all women with lupus,” preferably with testing for HPV, a type of virus that can be associated with cervical cancer, Dr. Lai-Shan Tam from Chinese University of Hong Kong, told AMN Health.

"We believe the result of HPV testing can help us to determine the frequency of subsequent screening,” the researcher added.

Tam’s team investigated the rate of abnormal Pap smears and associated factors in 85 women with lupus and 2080 healthy women.

Abnormal Pap smears were seen three times more often in lupus patients than in other women, the investigators report in the journal Arthritis & Rheumatism. Moreover, for certain high-risk findings, the risk was increased nearly sevenfold in lupus patients.

In addition to lupus, other risk factors for an abnormal Pap smear included a history of sexually transmitted disease, HPV infection, four or more sexual partners, early age of first sexual activity, and low education level.

Multiple HPV infections were more common among lupus patients than among other women, the researchers note, and infections with high-risk HPV types were nearly three times more likely in lupus patients than in controls.

“Physicians should be vigilant (about) this treatable condition,” Tam said, advising that lupus patients who are infected with high-risk types of HPV, such as type 16 and 18, should get a Pap smear every 6 months instead of every year.

SOURCE: Arthritis & Rheumatism, November 2004. 

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