Cervical human papillomavirus status among women with chronic inflammatory rheumatic diseases: matched cohort study.

Authors

Thomas Frisell, Johan Askling, Joakim Dillner, Karin Sundström

Published in

Journal of the National Cancer Institute. Aug 17, 2026. Epub Aug 17, 2026.

Abstract

Women with chronic inflammatory disorders such as rheumatoid arthritis (RA) and spondyloarthritis (SpA) are at increased risk for cervical precancer (CIN2+). It is unknown whether their human papillomavirus (HPV) status differs compared with a general screening population.
To determine whether cervical screening reliant on HPV16/18 detection would be appropriate also in RA/SpA.
We included women with (1) RA (n = 53 816) or (2) SpA (n = 25 496) who were naïve to biologic-/targeted synthetic-disease-modifying anti-rheumatic drugs (b/tsDMARD), (3) women with RA (n = 14 033) or (4) SpA (n = 8297) starting a first b/tsDMARD, and matched (1:5) general population comparators, n = 504 290). Incident HPV infection was categorized as positive for HPV16/18, and/or other (non-16/18) HPV types. Relative risks (RRs) were assessed through log-binomial regression.
Women with RA, whether exposed to b/tsDMARDs or not, had a higher prevalence of HPV (statistically significant RR of 1.17-1.18 vs comparators). Among women with SpA, risks were elevated in b/tsDMARD-exposed, as were other (non-16/18) HPV types. B/tsDMARD-naïve women with RA (but not those with bionaïve SpA) had higher risk for CIN2+ than comparators (RR = 1.20, 95% CI = 1.07 to 1.34). However, the proportion of women with CIN2+ positive for HPV16/18 or other HPV types did not differ vs comparators, neither in RA nor in SpA and whether b/tsDMARD-exposed or not.
Although some women with RA or SpA have higher risks for HPV and CIN2+ than the general population, their proportions of HPV16/18 vs other HPV types in CIN2+ do not differ. This is reassuring for cervical screening risk-stratifying women based on HPV16/18 detection.

PMID:
42606905
Bibliographic data and abstract were imported from PubMed on 18 Aug 2026.

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