Objectives: To compare cervical screening attendance and cytology (high- and low-grade cervical dysplasia: HGCD/LGCD) between (i) women with rheumatoid arthritis (RA) and the English general population, (ii) between biologic disease modifying anti-rheumatic drugs (bDMARD) naïve and exposed women.
Methods: The British Society for Rheumatology Biologics Register for RA (BSRBR-RA), a national prospective study of RA treatment outcomes, was linked to the NHS Cervical Screening Programme England, providing data for 12,785 women to compare with national screening data. Rates of HGCD/LGCD were compared with rates of negative smears using risk difference calculations between BSRBR-RA and national statistics. Within BSRBR-RA, coverage was compared between those with low and high physical disability scores, whilst coverage and cytology results were compared between bDMARD naïve and exposed RA patients.
Results: Mean 5-year screening coverage was significantly higher in BSRBR-RA (83%) compared with the general population (79%), but lower in women with high disability (78%) compared with lesser disability (85%). Risk differences for HGCD were lower in BSRBR-RA compared with national statistics, whereas risk differences for LGCD were higher. There was no statistically significant difference in the rates of HGCD or LGCD between bDMARD exposed and naïve women.
Conclusions: This first ever British analysis of cervical screening rates in RA has shown that women with RA have higher screening rates than the general population. Disability negatively impacts attendance, but treatment type does not. Women with RA did not have an increased risk of HGCD compared with national statistics, which was also not influenced by bDMARD exposure.