Danielle Kirelik, BS, Lauren Pascual, MPH, BS, Lillian Dawit, MD, Marie Borum, MD, EdD, MPH
George Washington University, Washington, DC
Introduction: Females with inflammatory bowel disease (IBD), specifically those on immunosuppressive therapy, may be at increased risk of cervical dysplasia and cervical cancer. Women with IBD have been reported to be screened less frequently than those at average risk. In addition, annual cervical cancer screening is recommended for IBD women who are on immunosuppressive therapy. This study evaluated the influence of provider gender on counseling for cervical cancer screening in IBD women.
Methods: A retrospective chart review of all IBD women seen in the gastroenterology clinic at a university medical center during a 5 year period was performed. Patient age, race, IBD diagnosis, medications, primary gastroenterology provider and documentation of cervical cancer screening or counseling within the past three years were recorded. Women who had a hysterectomy or those < 21 or > 65 years of age were excluded. A database was generated using Microsoft Excel. Statistical analysis was performed using Fisher’s Exact Test with significance set at P< 0.05. The study was approved by the institutional IRB.
Results: 218 IBD women were identified, with 192 women meeting criteria for analysis. 137 (71.35%) had Ulcerative Colitis (UC), 46 (23.96%) Crohn’s disease (CD), 5 (2.60%) microscopic colitis, and 4 (2.08%) indeterminate colitis. Mean age was 44.26 (range: 21-65). 98 (51.04%) were White, 53 (27.60%) Black/African American, 7 (3.65%) Asian, 6 (3.13%) Hispanic, 14 (7.29%) identified as other, and 14 (7.29%) declined to disclose. Male providers managed 125 (65.1%) and female providers managed 67 (34.9%) patients. 61 of 192 patients (31.77%) were counselled about cervical cancer screening. Female (50.75%; 34 of 67) versus male (21.6%; 27 of 125) providers counseled significantly more patients (p< 0.0001). There was no significant difference in the rate of counseling based on race (p=0.8724), age (≤40 versus >40) (p=0.5319), IBD diagnosis (p=0.5863), or medication type (p=0.6235).
Discussion: This study revealed that women with IBD were inconsistently counseled about cervical cancer screening. While female providers were significantly more likely to provide screening education, there was a clear need to improve counseling by all providers. Although this study was limited by retrospective design and single institution cohort, it highlights the need for patient education on the importance of cervical cancer screening to optimize clinical outcomes.
Citation: Danielle Kirelik, BS, Lauren Pascual, MPH, BS, Lillian Dawit, MD, Marie Borum, MD, EdD, MPH. P1398 - PUBLIC CERVIX ANNOUNCEMENT: PROVIDER GENDER MAY INFLUENCE CERVICAL CANCER SCREENING IN IBD WOMEN. Program No. P1398. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.