S891 Risk of Cervical Dysplasia/Cancer in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Introduction: There is inconsistent and conflicting evidence regarding the risk of cervical dysplasia/cancer in patients with inflammatory bowel disease (IBD). This systematic review was conducted to determine the risk of cervical abnormalities in patients with IBD and also estimate the comparative risk with respect to the general population. Methods: We searched various databases for studies which reported about rates of cervical intraepithelial neoplasia(CIN), cervical cancer or high risk HPV in IBD patients. We also extracted the rates of CIN, cervical cancer and high risk HPV in controls. Pooled prevalence of these lesions in IBD and relative risk in IBD patients in comparison to the healthy controls was estimated. We excluded studies which did not provide relevant data. All analysis were done in R version 4.1.1 using the meta and metafor packages. The random effects model was used with inverse variance approach for pooled prevalence and M-H method for calculation of relative risk. Results: We searched Embase, Medline and Pubmed and identified 522 relevant papers on 25th April 2022. Duplicates were removed and after initial screening, 44 papers were selected for full text screening. Eventually, 9 papers (5 case control and 4 cohort studies of 53,781 patients with IBD) were included in the quantitative synthesis. The pooled prevalence of CIN, cervical cancer and high risk HPV in the IBD population was 0.04 (0.01 - 0.11, I2= 100%). Patients with IBD were at a greater risk of cervical dysplasia/cancer when compared with healthy controls (relative risk 3.01, 1.44 - 6.31, I2= 100%). Conclusion: The patients with inflammatory bowel disease are at a heightened risk of developing cervical abnormalities like CIN,cervical cancer and high risk HPV lesions as compared to normal controls. These findings point to the importance of undergoing screening at regular intervals and significance of HPV vaccination in IBD patients in aiding to reduce the risk of developing cervical cancer.