The majority of cervical cancer cases are caused by the human papillomavirus virus (HPV) — or so we thought.

Lately other links have been investigated and among them, rheumatoid arthritis (RA).

Now, RA has been shown to be associated with cervical cancer.

And scientists are now faced with the question of what came first, the cancer or the RA? And did RA biologic treatment perhaps worsen or cause the cervical cancer?

Researchers hope to uncover the answers to these questions as they strive to better understand the complex, puzzling link between autoimmune inflammatory conditions and various forms of cancer.

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Biologic Drugs to Blame?

The overall risk of RA patients developing any form of cancer is at least 10 percent higher than that of the general population.

This risk can increase or decrease based on a number of factors including genetics, lifestyle, environment, medications, and coexisting conditions.

A recent study out of Sweden provided evidence that, at least in female RA patients, biologic drugs (in particular, TNF-inhibitors) could be to blame for a rise in virus-related cancers such as cervical cancer, as well as an increase in cervical dysplasia.

Female patients with rheumatoid arthritis who’ve never been on any type of biologic showed no significant difference from the general population when it came to risk for cervical dysplasia.

However, the study showed that younger women with RA who relied on anti-TNF therapy, also called T-cell inhibitors, were at an increased risk for cervical dysplasia and/or cervical cancer.

Additionally, this study found that while simply having rheumatoid arthritis alone appears to increase a female patient’s risk of developing cervical dysplasia, the young women being treated with a tumor necrosis factor inhibitor were at higher risk of dysplasia further developing into cervical cancer. 

“In an analysis of 34,984 women with RA not taking biologics, rates of cervical intraepithelial neoplasia were 53 percent higher and another type of cervical cancer, CIN2+, were 39 percent higher than in the general population,” reported Dr. Hjalmar Wadstrom of the Karolinska Institute in Stockholm, in a press statement. “However, women in whom a TNF inhibitor had been initiated had a 36 percent higher rate of CIN2+ and had double the risk of invasive cervical cancer compared with women with RA who were biologics-naïve.”

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Regular Screenings Suggested

The authors, however, caution that this casual link may not be a matter of concern just yet.

In order to stay safe, womenshealth.gov suggests that, “if you are between ages 21 and 29, you should get a Pap test every 3 years. If you are between ages 30 and 64, you should get a Pap test and HPV test together every 5 years, or a Pap test alone every 3 years. If you are 65 or older, ask your doctor if you can stop having Pap tests.”

Women who are immunocompromised, as are many with rheumatoid arthritis, should discuss more frequent screenings with their OB-GYN.

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