Brief communicationSexual health issues after lung transplantation: importance of cervical screening
Section snippets
Methods
We performed a retrospective cross-sectional study of all female lung transplant recipients who underwent transplantation between February 1989 and June 2001. Forty-six percent of lung transplant recipients at our institution were women. Papanicolaou (Pap) smears were performed in all female patients as part of our routine workup for transplantation if patients were ≥18 years or were sexually active. Our policy has been to recommend annual Pap smears after transplantation. All patients with
Results
Seventeen of 166 patients (10.2%) experienced cervical abnormalities at post-operative Day 957 ± 533 (range, 122–2,030). The mean age for these 17 patients was 39 ±13 (range, 23–56) years. Abnormalities included CIN 1 (n = 7), CIN 2 (n = 3), CIN 3 (n = 3), and HPV alone (n = 4). One patient with CIN 3 also had co-existing vulval intra-epithelial neoplasia Grade 3. Successful treatment included colposcopy and therapeutic cone biopsy (n = 3), Letz loop (n = 4), laser (n = 3), diathermy (n = 2),
Discussion
Human papillomavirus infection is one of the most prevalent sexually transmitted diseases. A strong correlation exists between high-risk HPV sub-types (16, 18, 31, 35, and 39) and high-grade CIN and the subsequent development of invasive carcinoma.9, 10 In non-immunosuppressed women, the mean age of women with CIN is approximately 15 years younger than that of women with invasive cancer, suggesting slow progression of CIN to invasive carcinoma.11
A large prospective study by Richart and Barron12
Conclusions
Although the impact of immunosuppression on the development of cervical dysplasia or on the rate of progression to invasive cervical cancer in lung transplant recipients is unknown, impaired clearance of the virus probably exists because of immunosuppression. Our data suggest that the incidence of cervical abnormalities in lung transplant recipients is significantly greater than in the general population.
The importance of regular surveillance in immunosuppressed patients to allow early
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Family Planning and Reproductive Health in Cystic Fibrosis
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2021, Journal of Clinical and Translational EndocrinologyCitation Excerpt :They report similar rates of human papilloma virus vaccination compared with the general population, although the majority remain unvaccinated [58]. Data from an older cohort of French females with CF similarly confirm low utilization of gynecologic healthcare, with only 55% reporting any history of cervical cancer screening [61], despite elevated rates of cervical dysplasia in the CF population, especially after transplant [62,63]. In the U.S., CF patients and providers alike recognize the importance of SRH and that health discussions should begin in early adolescence [64,65].
Gynecologic cancers and solid organ transplantation
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