Brown University / Rhode Island Hospital Providence, RI
Joshua D. Long, MD1, Aneesha Gummadi, MD1, Emily Romanoff, MD1, Adam Burton, MD1, Harlan Rich, MD1, Sean Fine, MD2 1Brown University, Providence, RI; 2Brown University / Rhode Island Hospital, Providence, RI Introduction: Patients with IBD on immunosuppressive medications are at increased risk of developing low-grade cervical lesions, high-grade cervical dysplasia, and cervical cancer. ACG Clinical Guidelines for Preventative Care recommend annual cervical cancer screening for women on chronic immunosuppression and HPV vaccination in all IBD patients. We evaluated the adherence to these guidelines, as well as ACOG guidelines, in our IBD clinic. We also assessed the percentage of patients in our IBD clinic who completed a full HPV vaccination series. Methods: We performed a retrospective chart review of all patients in our IBD clinic through 2024. Female patients with an IBD diagnosis and ≥1 prescription for immunosuppressive therapy were included. ACG guideline compliance was defined as ≥1 Papanicolaou (Pap) smear annually, beginning at initiation of immunosuppressive therapy. ACOG guideline compliance was defined as: one Pap smear every 3 years for women aged 21-29; one Pap smear and HPV co-testing every 5 years, or one Pap smear every 3 years, or HPV testing alone every 5 years for women 30-65. A full schedule of HPV vaccination was defined as completion of either the 2- or 3-dose vaccination series. Descriptive statistics were used to calculate overall adherence rates. Results: 70 patients met inclusion criteria. 17% (12/70) completed a full HPV vaccination series. 36% (25/70) received ≥1 dose of an HPV vaccine. 13 patients received either incomplete or improperly timed doses of HPV vaccines. 9% (6/70) were compliant with ACG guidelines for cervical cancer surveillance while 61% (43/70) were compliant with ACOG guidelines (compared to 67% at our primary care clinic in the same location). Barriers to providing this care included lack of awareness of current ACG guidelines, logistical challenges in coordinating care for required testing and vaccinations in the allotted time, and patient unwillingness or inability to complete invasive testing yearly. Discussion: Our data demonstrate that compliance with ACG guidelines for cervical cancer screening is poor in our IBD clinic, which is consistent with earlier studies. These findings suggest that there are significant challenges in coordinating annual cervical cancer screening in patients with IBD. Raising awareness of this issue, improving patient education, and introducing programmatic screening within the field of gastroenterology, as well as amongst our primary care and OB/GYN colleagues, will be paramount to improving compliance with these guidelines.
Figure: Table 1. Compliance rates with a full schedule of HPV vaccination, ACG’s Clinical Guidelines for Preventative Care in Inflammatory Bowel Disease for Cervical Cancer, and ACOG’s Updated Cervical Cancer Screening Guidelines in IBD patients on immunosuppressive medications in our IBD Clinic.
Disclosures: Joshua D. Long indicated no relevant financial relationships. Aneesha Gummadi indicated no relevant financial relationships. Emily Romanoff indicated no relevant financial relationships. Adam Burton indicated no relevant financial relationships. Harlan Rich indicated no relevant financial relationships. Sean Fine indicated no relevant financial relationships.
Joshua D. Long, MD1, Aneesha Gummadi, MD1, Emily Romanoff, MD1, Adam Burton, MD1, Harlan Rich, MD1, Sean Fine, MD2. P1144 - Adherence to Cervical Cancer Screening and HPV Vaccination Recommendations Amongst IBD Patients on Immunosuppressive Medications, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
