Cervical cancer screening delayed in women with RA

Cervical cancer screening tends to be delayed among women with rheumatoid arthritis (RA) relative to those without RA, reports a study. 

Furthermore, patients with both RA and obesity have a lower risk of delay in breast cancer screening, while those with RA and a smoking history show a decrease in prostate cancer screening.

“Our study suggests that increased awareness of cervical cancer screening by healthcare providers may help ensure patients with RA receive screening,” the researchers said.

A total of 1,614 patients with RA and 1,597 comparators without RA (mean age 63 years, 71 percent female) were included in the study. [J Rheum 2025;52:988-996]

Of the patients, 51.6 percent (95 percent confidence interval [CI], 47.9–55.6) in the RA cohort vs 58.2 percent (95 percent CI, 54.5–62.2) in the non-RA cohort underwent cervical cancer screening at 5 years of follow-up. After adjusting for age, race, and smoking, RA correlated with reduced cervical cancer screening (adjusted hazard ratio [aHR], 0.83, 95 percent CI, 0.72–0.96).

On the other hand, RA showed no significant association with a reduction in breast (aHR, 0.98, 95 percent CI, 0.87–1.10), prostate (aHR, 0.99, 95 percent CI, 0.74–1.34), or colorectal (aHR, 95 percent CI, 0.93–1.16) cancer screening.

Lack of resources

“We found individuals with RA had decreased cervical cancer screening compared to non-RA comparators, and although we hypothesized that patients with RA would have a significant delay in breast, prostate, and colorectal cancer screenings, this was not shown in our study,” the researchers said.

“The observed decrease in cervical cancer screening in patients with RA is likely multifactorial and due to similar reasons as seen in the general population, such as lack of resources and health insurance,” they added. [Cells 2019;8:622]

The researchers also noted the importance of awareness of the risk of delay in cervical cancer screening among women with RA since many of the cervical cancer diagnoses and related deaths occur in those who did not undergo screening. Moreover, the survival rate at 5 years for this type of cancer is <70 percent once diagnosed. [https://tinyurl.com/mt6j7eye]

Notably, screening through cytology every 3 years or high-risk human papillomavirus testing every 5 years reduces cervical cancer-related deaths to 0.74 and 0.29 deaths per 1,000 women, respectively. [JAMA 2018;320:674-686]

Study cohorts

The current retrospective, matched cohort study included patients with and without RA living in an 8-county region of southern Minnesota, US, on 1 January 2015. 

The researchers reviewed medical records to identify patients who fulfilled either the 1987 American College of Rheumatology (ACR) or 2010 ACR/European Alliance of Associations for Rheumatology classification criteria for RA. They matched eligible patients 1:1 to non-RA comparators based on age, sex, and county of residence.

Review of the US Preventive Task Force recommendations determined the cancer screening. Finally, the researchers estimated the cumulative incidence of cancer screening, accounting for the competing risk of death, and assessed the risk of delay using Cox proportional hazard models adjusted for age, race, and smoking.