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EP391 Rheumatoid arthritis as a risk factor for cervical cancer in brazil
  1. L Resende1 and
  2. N Goulart2
  1. 1UniCeub
  2. 2Clinica Revigore, Brasilia, Brazil


Introduction/Background Rheumatoid arthritis (RA) is a chronic, polygenic, multifactorial disease that has a systemic inflammatory response.

The prevalence in the world is 1–2% in Western countries. In the United Kingdom, affects about 400,000 people; is more prevalent in women (3:1). In Brazil it is estimated a prevalence of 0.5–1% and age range that ranges between 30–50 years.

Treatment involves the use of anti-rheumatic drug modifying the disease, associated or not with the use of glucocorticoids. Cervical cancer ranks third in prevalence and fourth as cause of death in women worldwide. In Brazil, this disease still represents an important cause of death among women. Persistent High risk HPV (HR-HPV) infection is a necessary condition for the onset of precursor lesions that can progress to cancer.

Methodology 131 women with HR-HPV positive test, of those 42 diagnosed with rheumatoid arthritis and 89 without autoimmune disease. Oncotic cytology, genotyping for HPV and colposcopy were performed at intervals of 2 years.

Results The mean age (years) of both groups was 34.7 (RA) and 32.1 (Control). The persistence of HR-HPV infection after 2 years was higher in the study group (61 vs 28%) and the presence of abnormal cytologies was also higher (9.3 vs 2.1%).

Conclusion Young women have a high rate of negative HPV infection within 2 years. Some studies have evidence that the exposition to long-term immunosuppression increase the risk of pre-invasive cervical lesions than the general population which can be explained by increased persistence of HPV infection, especially HPV 16 and 18. This Brazilian cohort has a small number of women, but has similar statistics to studies in other countries, which also shows an increased risk of those using corticosteroids to develop cervical cancer precursor lesions and, therefore, need an interval tracing time, associated with colposcopy with biopsies for histological confirmation.

Disclosure Nothing to disclose.

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