Race and socioeconomic status play a major role in many health disparities, and a new study suggests that many African American women with systemic lupus erythematosus (SLE)—and their physicians—underestimate their risk for cervical cancer. This lack of understanding only increases the risk more, researchers say, highlighting the need for better education and intervention strategies.
Takeaways
- Race and socioeconomic status significantly impact health disparities, particularly in African American women with systemic lupus erythematosus (SLE), who underestimate their risk of cervical cancer.
- African American women with SLE undergoing immunosuppressive treatment are at a higher risk of developing cervical cancer and related diseases, such as human papillomavirus (HPV) infections.
- Despite 70% of the women in the study being aware of the link between HPV and cervical cancer, they lacked knowledge about other HPV-related health issues and prevention methods.
- High-risk factors for HPV and cervical infections among these women included multiple sexual partners, lack of HPV vaccination, cigarette smoking, and insufficient condom use.
- The study emphasizes the need for better education, awareness, and access to testing in high-risk groups like African American women with SLE to reduce rates of HPV infection and cervical cancer.
Inflammatory diseases that are treated with immunosuppressive medications are known to increase patient’s risk of various infections and comorbidities, but the study examined the specific relationship between systemic erythematosus lupus (SLE) and the risk of cervical cancer. The team found that African American women being treated for SLE were prone to higher rates of cervical cancer and other diseases related to sexually transmitted infections like human papilloma virus (HPV).
The research team found that not only was there a link between SLE and cervical cancer but noted that even though 70% of the women polled in the study knew about the link between human papilloma virus (HPV) and cervical cancer, few knew about how the risk of many other cervical health issues—or how to prevent them.
The study, published in Women’s Health Reports, used self-samples of cervical cells from 30 African American women between the ages of 18 and 50 years. All of them had moderate to severe SLE and were being treated with immunosuppressive medications. Most of the women in the study were in their mid- to late-30s, and 63% had a history of a prior abnormal pap smear.
Beyond immunosuppression, some other risk factors for HPV and other cervical infections that were identified among the study participants included things like:
- Multiple sexual partners
- Not being vaccinated against HPV
- Cigarette smoking
- Lack of condom use or other barrier methods
The team found that while 70% of the participants in the study understood that HPV infection could lead to cervical cancer, few knew about any other HPV-related diseases or infections.
When tested, HPV DNA was found in 70% of the cohort. Multiple HPV varieties were identified, and every individual who carried HPV DNA also had an active HPV infection. More than 13% of the participants in the study also already had some form of abnormal cytology, according to the study.
The research team points out that this study sample highlights how HPV infection can develop in a variety of ways with no consistent patterns. The study also stresses the need for better, more effective education for African American women about their already elevated risk for SLE and cervical cancer, and the relationship between these two diseases.
Beyond biological racial and ethnic factors that may play a role in the increased risks of both SLE and cervical cancer, most of the women in the study also had increased socioeconomic disparities that may have played a role in their lack of education, the study notes. Nearly 90% of the cohort was reliant on Medicaid or Medicare for their healthcare, and only 4 participants had commercial insurance coverage.
The research team suggested that patients weren’t the only ones unaware of the increased risk of cervical cancers in African American women with SLE, either. Their primary care providers were also likely unaware and may not have increased education and monitoring to match this risk.
The authors suggest that better awareness, education, and access to testing in high-risk groups like the one sampled could help lower rates of HPV infection and cervical cancers. The self-sampling brush used in the study was reported as easy to use by the cohort and could be an option to help increase options for low-cost, accessible testing, the team suggests.
More research is needed to fully understand how the biology of HPV infection in African American women with SLE and how it increases cancer risk, the study notes. In the meantime, however, physicians and patients should focus on advocating for better testing, surveillance, education, and intervention strategies in women known to have these high risks, the study concludes.
References:
Dhar JP, Walline H, Mor G, et al. Cervical Health in Systemic Lupus Erythematosus. Womens Health Rep (New Rochelle). 2023;4(1):328-337. Published 2023 Jul 12. doi:10.1089/whr.2023.0023
