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Objectives To evaluate the prevalence of cervical abnormalities in patients with SLE and their association with risk factors.Methods Observational and retrospective cohort study of 339 SLE patients followed at a university hospital in Northern Spain. Cytologies and HPV detection were collected according to regional clinical practice guidelines. Lesions were classified according to The Bethesda System as: Atypical Squamous Cells of Undetermined Significance (ASC-US), Low-Grade Squamous Intraepithelial Lesions (LSIL), High-Grade Squamous Intraepithelial Lesions (HSIL), and invasive squamous cell carcinoma.Results A total of 339 patients, mostly Caucasian (91.4%), diagnosed with SLE were included in the study ( table 1), with a mean age of 53.2± 14.6 years, with a predominance of females (n= 302, 89.1%). Patients were followed-up during a median of 127 [46-263] months. 260 patients underwent cervical cytology and 21 of them (8%) had abnormal results.Among these, 9.5% of patients had ASC-US (50% smokers; none HPV-positive), 28.6% had LSIL (83.3% HPV-positive; 66.7% with high-risk serotypes), and 42.9% had HSIL (55.5% smokers; 88.9% HPV-positive; 55.5% with high-risk serotypes; 22.2% had received cyclophosphamide).One middle-aged woman developed stage IIIB squamous cell carcinoma of the cervix with lymph node and pelvic involvement. She had received cyclophosphamide and tested positive for a high-risk HPV serotype (table 2). In addition, one male patient developed anal intraepithelial neoplasia, with confirmed high-risk HPV positivity.Abstract PO:07:190 Table 1–2Conclusions HPV infection is relatively frequent in patients with SLE. Rigorous cervical cancer screening protocols, including annual cytology, may be necessary to ensure early identification of precancerous and cancerous lesions in this high-risk population.