Adherence to cervical cancer screening in an Italian SLE cohort

Objective: Papanicolau (Pap) smear abnormalities are more frequently observed in systemic lupus erythematosus (SLE) respect to the general population. The primary objective of the present study was to evaluate the adherence to cervical cancer (CC) screening in an Italian cohort of SLE patients and, secondly, to evaluate the disease-related factors possibly influencing the patients’ behavior. Methods: Consecutive 25 to 64 year old SLE patients and aged- matched healthy women were enrolled for the study. All patients were interviewed during ambulatory visits, at admission to the clinic or by a telephone contact; disease related variables were also collected from the clinical charts. Results: 140 SLE patients (mean age 48.3±12 years) and 70 controls matched for demographic and sociocultural characteristics were enrolled. Ninety-three SLE patients (66.4%) declared to perform the Pap test at least every three years (23.6% yearly and 42.8% when asked by the screening programs) while 47 (33.6%) did not perform regular CC screening (16.4% never did the test and 17.1% only occasionally). No significant differences were observed between patients and controls in cancer screening adherence. No significant associations were observed between the screening program behaviours and disease-related variables. Conclusions: Despite the growing evidence of an increased risk of CC in SLE, and regardless of the broad availability of screening programs and official recommendations, our results show insufficient CC surveillance among SLE patients and emphasize to rheumatologists and/or general practitioners the importance to discuss with patients this aspect during routine evaluations in order to encourage compliance to the recommended preventive measures.