Women with Inflammatory Bowel Disease Are Not at Risk of Abnormal Cervical Cytology: Results of a Retrospective Study

Introduction: Existing data on cervical intraepithelial neoplasia (CIN) in individuals with inflammatory bowel disease (IBD) are inconsistent. The aim of this study was to evaluate the prevalence of abnormal cervical cytology among patients with IBD. Methods: A retrospective analysis was conducted using digital records from patients with IBD, including those receiving immunosuppressive therapy, small molecules, or biological treatments, to assess the influence of these therapies on cervical cytology results. Results: Data were collected from 301 patients with IBD (150 with Crohn’s disease [50.3%] and 151 with ulcerative colitis [49.8%]) and 40 control patients. The mean age in the IBD group was 36.96 ± 11.92 years for Crohn’s disease and 43.19 ± 14.42 years for ulcerative colitis (mean difference = -6.23, 95% CI [-9.23; -3.23]), while the control group had a mean age of 36.55 ± 12.70 years. Deviations from normal findings in the most recent cytology were observed in 6 IBD patients (2.3%) compared to 8 control patients (20.0%), OR = 0.10, 95% CI [0.03; 0.34], p < 0.001. Deviations from normal findings in the most recent cytology or any previous cytology were identified in 25 IBD patients (9.0%) versus 9 controls patients (22.5%), OR = 0.34, 95% CI [0.14; 0.91], p = 0.021. No significant differences were found between the IBD subgroups regarding smoking status, current or past exposure to immunosuppressive drugs, or frequency of gynaecological examinations. The frequency of biological treatment was higher in Crohn’s disease patients (88.0%) compared to those with ulcerative colitis (74.2%) (OR = 2.55, 95% CI [1.36; 5.01], p = 0.003). Conclusions: Women with IBD exhibited a lower risk of cervical dysplasia compared to healthy controls, independent of treatment type. However, rigorous malignancy surveillance, including regular cervical cytology, remains essential to facilitate early detection of dysplasia.