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Abstract

Objective: Given recent concerns about cervical dysplasia with RA medications, we performed a literature review and a pooled analysis to examine the relative risk of cervical and vaginal cancers in RA.
Methods: We conducted a literature search covering 2007- 2014. A pooled analysis was conducted: the total numbers of cancers expected and observed across all studies were respectively summed for different cancer types (cervical and vaginal/vulvar cancers). As some studies pooled vaginal and vulvar cancers together, we did not discern between the two for the purpose of this study. Using these pooled estimates, standardized incidence ratios (SIRs) were calculated, demonstrating the relative risk of the cancers in RA, versus the general population.
Results: Our search strategy retrieved 13 papers. Our pooled SIR estimates were 0.82, 95% confidence interval, CI, 0.73-0.92 for cervical cancer in RA and 1.04, 95% CI 0.80-1.34 for vaginal/vulvar cancer in RA.
Conclusion: Our simple pooled analysis was consistent with a relatively lower cervical cancer risk in RA versus the general population, while the data did not establish if the risk of vaginal/vulvar cancer was different from the general population. Cervical cancer screening in RA will continue to be important, particularly as evolving treatment strategies may affect future risk.