Stratified and subgroup analyses: fully adjusted* HRs for high-grade cervical dysplasia and cervical cancer in patients with SID compared with those without SID
| SID | IBD | Psoriasis | RA | SLE | Non-SID | |
|---|---|---|---|---|---|---|
| Pap smears or HPV-DNA testing done at baseline | ||||||
| Yes | ||||||
| N | 58 110 | 12 623 | 15 795 | 23 362 | 6330 | 220 766 |
| Outcomes | 163 | 42 | 38 | 61 | 22 | 468 |
| HR (95% CI) | 1.27 (1.01 to 1.60) | 1.23 (0.85 to 1.77) | 1.03 (0.73 to 1.46) | 1.73 (1.18 to 2.59) | 1.60 (0.98 to 2.59) | Ref |
| No | ||||||
| N | 75 223 | 12 553 | 18 870 | 35 617 | 8183 | 312 566 |
| Outcomes | 96 | 17 | 20 | 41 | 18 | 350 |
| HR (95% CI) | 1.01 (0.75 to 1.35) | 0.82 (0.48 to 1.41) | 0.85 (0.53 to 1.35) | 1.21 (0.77 to 1.92) | 1.46 (0.86 to 2.50) | Ref |
| Prior abnormal Pap smears | ||||||
| Yes | ||||||
| N | 5339 | 1267 | 1456 | 1929 | 687 | 17 589 |
| Outcomes | 81 | 19 | 21 | 32 | 9 | 220 |
| HR (95% CI) | 1.23 (0.88 to 1.70) | 0.90 (0.52 to 1.55) | 1.17 (0.73 to 1.86) | 2.19 (1.29 to 3.72) | 1.18 (0.56 to 2.51) | Ref |
| No | ||||||
| N | 127 994 | 23 909 | 33 209 | 57 050 | 13 826 | 515 743 |
| Outcomes | 178 | 40 | 37 | 70 | 31 | 598 |
| HR (95% CI) | 1.13 (0.92 to 1.41) | 1.13 (0.78 to 1.63) | 0.87 (0.62 to 1.23) | 1.31 (0.92 to 1.87) | 1.71 (1.14 to 2.56) | Ref |
| At least one gynaecological visit or procedure during the follow-up time | ||||||
| Yes | ||||||
| N | 70 753 | 14 969 | 19 072 | 28 929 | 7783 | 267 823 |
| Outcomes | 259 | 59 | 58 | 102 | 40 | 817 |
| HR (95% CI) | 1.14 (0.95 to 1.36) | 1.03 (0.76 to 1.39) | 0.94 (0.71 to 1.24) | 1.53 (1.13 to 2.06) | 1.52 (1.06 to 2.18) | Ref |
| Use of systemic immunosuppressive drugs at baseline† | ||||||
| Yes | ||||||
| N | 46 626 | 3150 | 6862 | 33 568 | 3046 | 533 332‡ |
| Outcomes | 85 | 10 | 11 | 52 | 12 | 818 |
| HR (95% CI) | 1.31 (0.97 to 1.77) | 1.72 (0.66 to 4.45) | 1.04 (0.43 to 2.51) | 1.40 (0.65 to 3.03) | 1.52 (0.64 to 3.61) | Ref |
| No | ||||||
| N | 86 707 | 22 026 | 27 803 | 25 411 | 11 467 | 533 332‡ |
| Outcomes | 174 | 49 | 47 | 50 | 28 | 818 |
| HR (95% CI) | 1.15 (0.95 to 1.39) | 1.02 (0.73 to 1.42) | 0.96 (0.71 to 1.30) | 1.73 (1.21 to 2.47) | 1.53 (1.00 to 2.35) | Ref |
| Use of systemic steroids at baseline | ||||||
| Yes | ||||||
| N | 50 208 | 6814 | 5820 | 30 831 | 6743 | 533 332‡ |
| Outcomes | 102 | 19 | 5 | 55 | 23 | 818 |
| HR (95% CI) | 1.33 (1.00 to 1.76) | 1.30 (0.79 to 2.13) | 0.62 (0.25 to 1.50) | 1.49 (1.00 to 2.21) | 1.69 (1.05 to 2.72) | Ref |
| No | ||||||
| N | 83 125 | 18 362 | 28 845 | 28 148 | 7770 | 533 332‡ |
| Outcomes | 157 | 40 | 53 | 47 | 17 | 818 |
| HR (95% CI) | 1.14 (0.93 to 1.41) | 1.04 (0.73 to 1.48) | 1.04 (0.78 to 1.39) | 1.59 (1.06 to 2.38) | 1.45 (0.87 to 2.42) | Ref |
*Adjusted for age, comorbidity score, number of prescription drugs, alcoholism, smoking, substance abuse, being sexually active, diagnosis of sexually transmitted disease, oral and non-oral contraceptive use, receipt of HPV vaccine, diabetes, chronic kidney disease, liver disease, use of systemic immunosuppressive drugs, systemic steroids and non-steroidal anti-inflammatory drugs, healthcare utilisation factors and preventive medical services.
†Systemic immunosuppressive drugs include azathioprine, cyclophosphamide, ciclosporin, hydroxyurea, leflunomide, methotrexate, 6-mercaptopurine, mycophenolate, pimecrolimus, tacrolimus, abatacept, adalimumab, alefacept, anakinra, certolizumab pegol, etanercept, golimumab, infliximab, rituximab, tocilizumab and ustekinumab.
‡The entire non-SID cohort was used as a comparison.
HPV, human papillomavirus; IBD, inflammatory bowel disease; RA, rheumatoid arthritis; SID, systemic inflammatory disease; SLE, systemic lupus erythematosus.