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Cervical cancer screening abnormalities in immunosuppressed renal transplant women: case–control study in Southern Brazil

  • General Gynecology
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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the prevalence of cervical pre-malignancies in the cervical cytology of female renal transplant recipients (RTR) and compare to immunocompetent patients.

Methods

A prospective case–control study of 165 RTR (cases) and 372 immunocompetent women (controls) was carried out from May 2015 to August 2016. The participants completed a questionnaire with demographic characteristics, habits, reproductive history, and information about the renal transplant. Cervical cytology samples were collected at their visit for cervical cancer screening. Relevant medical history was obtained from medical records and previous cervical cytology results were retrieved: from the time of kidney transplantation to the beginning of this study for RTR and all collected throughout life for controls.

Results

The mean age was similar between groups (42.6 ± 11.4 vs. 41.8.2 ± 11.1 years, p = 0.447). Considering cervical cytology collected since the kidney transplant, RTR had three times higher rates of abnormal cervical cytology test (24.8% of RTR vs. 6.3% for controls), and the abnormalities were more frequent (p < 0.001) for low squamous intraepithelial lesion (LSIL) (n = 23, 13.9%) and high squamous intraepithelial lesion (HSIL) (n = 9, 5.5%). Cervical cytology collected during the study had normal results in 152 RTR (92.1%) vs. 326 controls (93.9%) (p > 0.05). When the altered results were broken down, a higher frequency of LSIL could be seen in RTR (3.6% vs 0.0%, p = 0.008).

Conclusion

RTR had significantly higher rates of cervical cytology abnormalities comparing to the control group and most of it was composed of LSIL.

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Funding

The authors received no specific funding for this work.

Author information

Authors and Affiliations

  1. Graduate Program in Health Sciences: Gynecology and Obstetrics, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil

    Sibele Klitzke, Mila Pontremoli Salcedo & Suzana Arenhart Pessini

  2. School of Medicine, Pontifícia Universidade Católica Do Rio Grande Do Sul (PUCRS), Porto Alegre, RS, Brazil

    Isabella Osorio Wender

  3. Department of Obstetrics and Gynecology, Universidade Federal de Ciências da Saúde de Porto Alegre/Irmandade Santa Casa de Misericórdia, Porto Alegre, Brazil

    Mila Pontremoli Salcedo

  4. Department of Obstetrics and Gynecology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil

    Suzana Arenhart Pessini

Authors
  1. Sibele Klitzke
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  2. Isabella Osorio Wender
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  3. Mila Pontremoli Salcedo
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  4. Suzana Arenhart Pessini
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Contributions

S Klitzke: project development; patients’ clinical examination; data collection; data analysis, manuscript writing and editing. IO Wender: data analysis; manuscript writing and editing. MP Salcedo: data analysis; manuscript review and editing. SA Pessini: project development; patients’ clinical examination; data analysis; writing review and editing/supervision.

Corresponding author

Correspondence to Suzana Arenhart Pessini.

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Conflicts of interest

The authors declared no conflicts of interest.

Ethics approval

This study was approved by the Research Ethics Committee of the Gynecologic Clinic of Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA) under protocol number: 078.827/2014 and was performed in line with the principles of the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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All original sources of data are available.

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Klitzke, S., Wender, I.O., Salcedo, M.P. et al. Cervical cancer screening abnormalities in immunosuppressed renal transplant women: case–control study in Southern Brazil. Arch Gynecol Obstet 302, 649–655 (2020). https://doi.org/10.1007/s00404-020-05621-3

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  • DOI: https://doi.org/10.1007/s00404-020-05621-3

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