Contributions
Abstract: EP1436
Type: ePoster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background and aims: The risk of persistent Human Papillomavirus (HPV) infection, cervical dysplasia and HPV-related cancers is unknown in women with multiple sclerosis (MS). Given the long-term and serial exposure of patients to immunomodulatory and immunosuppressive treatments, it is important to determine the prevalence of cervical dysplasia in the MS population compared to other women. Understanding this risk may help guide vaccination guidelines for the highly effective HPV vaccine in this population.
Methods: We identified all women aged 18 to 70 with a primary diagnosis coded at hospital separation as MS through the Victorian Admitted Episode Database. The cervical screening history of this cohort was identified using probabilistic data linkage to women who had at least one cervical screening episode between 2009 - 2013 recorded on the Victorian Cervical Cytology Registry. Cervical dysplasia outcomes identified were: cytological low- and high-grade abnormalities (LGA, HGA) and histologically confirmed abnormalities (HisA). Results were stratified by age and intergroup comparisons were performed.
Results: A cohort of 2382 patients with MS was identified, and compared with 929,670 women in the general population. Overall, the results show a similar proportion of cytological and histological abnormalities between the MS cohort and the general population. In the MS cohort, 7.18% had LGA, 2.35% had HGA, and 1.68% had HisA; these rates were 6.84%, 2.46% and 2.31%, respectively, in the general population. In the younger age groups (25-34 years), the MS cohort had higher rates of all abnormalities, but these rates dropped below that of the general population in the later age groups
(60-69 years).
Conclusion: The data demonstrates similar rates of cervical dysplasia for women with MS and the general Victorian population. While the results are reassuring, the lack of data on DMT-exposure makes it difficult to assess risk on an individual basis. Physicians should remain vigilant and recommend screening and vaccination to all patients with multiple sclerosis.
Disclosure:
Emma Foster: Nothing to disclose.
Michael Malloy: Nothing to disclose.
Vilija Jokubaitis: Nothing to disclose.
C. David Wrede: Nothing to disclose.
Helmut Butzkueven: Research support from Biogen, Novartis, Merck; Advisory board and speaker fees from Roche, Biogen, Novartis, Merck, Teva, Medscape, Oxford Pharmagenesis
Ai-Lan Nguyen: Novartis, Biogen, Merck Serono
Julia Brotherton: investigator on investigator initiated unrestricted epidemiological research partially funded by Merck/Seqirus but has never received any personal financial benefits.
Anneke van der Walt: NHMRC Australia; has received travel support, speaker´s honoraria, and served on advisory boards for Biogen, Novartis, Merck and Teva.
Abstract: EP1436
Type: ePoster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background and aims: The risk of persistent Human Papillomavirus (HPV) infection, cervical dysplasia and HPV-related cancers is unknown in women with multiple sclerosis (MS). Given the long-term and serial exposure of patients to immunomodulatory and immunosuppressive treatments, it is important to determine the prevalence of cervical dysplasia in the MS population compared to other women. Understanding this risk may help guide vaccination guidelines for the highly effective HPV vaccine in this population.
Methods: We identified all women aged 18 to 70 with a primary diagnosis coded at hospital separation as MS through the Victorian Admitted Episode Database. The cervical screening history of this cohort was identified using probabilistic data linkage to women who had at least one cervical screening episode between 2009 - 2013 recorded on the Victorian Cervical Cytology Registry. Cervical dysplasia outcomes identified were: cytological low- and high-grade abnormalities (LGA, HGA) and histologically confirmed abnormalities (HisA). Results were stratified by age and intergroup comparisons were performed.
Results: A cohort of 2382 patients with MS was identified, and compared with 929,670 women in the general population. Overall, the results show a similar proportion of cytological and histological abnormalities between the MS cohort and the general population. In the MS cohort, 7.18% had LGA, 2.35% had HGA, and 1.68% had HisA; these rates were 6.84%, 2.46% and 2.31%, respectively, in the general population. In the younger age groups (25-34 years), the MS cohort had higher rates of all abnormalities, but these rates dropped below that of the general population in the later age groups
(60-69 years).
Conclusion: The data demonstrates similar rates of cervical dysplasia for women with MS and the general Victorian population. While the results are reassuring, the lack of data on DMT-exposure makes it difficult to assess risk on an individual basis. Physicians should remain vigilant and recommend screening and vaccination to all patients with multiple sclerosis.
Disclosure:
Emma Foster: Nothing to disclose.
Michael Malloy: Nothing to disclose.
Vilija Jokubaitis: Nothing to disclose.
C. David Wrede: Nothing to disclose.
Helmut Butzkueven: Research support from Biogen, Novartis, Merck; Advisory board and speaker fees from Roche, Biogen, Novartis, Merck, Teva, Medscape, Oxford Pharmagenesis
Ai-Lan Nguyen: Novartis, Biogen, Merck Serono
Julia Brotherton: investigator on investigator initiated unrestricted epidemiological research partially funded by Merck/Seqirus but has never received any personal financial benefits.
Anneke van der Walt: NHMRC Australia; has received travel support, speaker´s honoraria, and served on advisory boards for Biogen, Novartis, Merck and Teva.