Document resource
Introduction Women with immune-mediated inflammatory diseases (IMIDs) are at an increased risk of human papillomavirus (HPV)-related cervical cancer. Our study aimed to assess the risk of HPV-induced cervical, vaginal, vulvar, anal and penile cancer in patients with IMIDs.Methods We conducted a nationwide matched cohort study comparing patients with IMIDs with a control group using the French nationwide hospital medical information database between 2016 and 2023. The following IMIDs were considered: systemic lupus erythematosus (SLE), Sjögren’s syndrome, systemic sclerosis, mixed connective tissue disease and rheumatoid arthritis. The primary outcome was the occurrence of HPV-induced cancer or severe dysplasia.Results A total of 122 316 patients with IMIDs and 316 047 matched controls were analysed over an 8-year study period, with a mean follow-up of 4.11 (2.47) years. IMIDs were associated with an increased risk of HPV-induced cancer or severe dysplasia (age-adjusted HR 1.99 (95% CI 1.80 to 2.20)) in all patients with IMIDs compared with matched controls. An increased risk was observed in patients with IMIDs for all types of HPV-induced cancer except penile cancer. In the multivariable competing risk analysis, the risk factors for HPV-induced cancer/severe dysplasia in the IMIDs population were female (HR: 5.88 (95% CI 4.01 to 8.61)), SLE (HR: 2.08 (95% CI 1.70 to 2.55)), age under 65 years (HR: 2.09 (95% CI 1.70 to 2.57)) and chronic kidney disease (HR: 1.44 (95% CI 1.18 to 1.77)).Conclusion Patients with IMIDs are almost two times as likely to develop HPV-associated cancer or severe dysplasia, particularly at cervical, vulvar, vaginal and anal sites, compared with matched controls.