P-027 YI Are Patients With Inflammatory Bowel Disease on Chronic Immunosuppressive Therapy at Increased Risk of Cervical High-Grade Dysplasia/Cancer? A Meta-Analysis
Notice bibliographique
Résumé
Immunosuppression is a mainstay of therapy for both induction and maintenance of remission for moderate to severe inflammatory bowel disease (IBD). Women who are chronically immunosuppressed have been shown to be at higher risk of developing cervical high-grade dysplasia and/or carcinoma. There is contradictory data whether immunosuppressed patients with IBD have the same risk profile for cervical cancer as patients who are chronically immunosuppressed secondary to solid organ transplant or HIV infection. To determine if the risk of cervical high-grade dysplasia and/or cancer is higher in patients with IBD on immunosuppressive therapy compared to the rates in the general population. Data sources: A systematic review of English articles was performed using PubMed (1980–2014), Web of Science (1980–2014), and Embase (1980–2014). Additional studies were identified by searching bibliographies as well as abstracts. Search terms included Inflammatory Bowel Disease, Crohn’s Disease (CD), Ulcerative Colitis (UC), cervical cancer, and cervical dysplasia. The studies were restricted to full text retrospective cohort studies and case controls that had a high (6–9) Newcastle- Ottawa Score. These studies addressed rates of cervical high-grade dysplasia and cancer in patients with IBD on immunosuppressive medications compared to the general population. Independent extraction of articles by 3 authors using predefined data fields, as well as the Newcastle-Ottawa Scale for study quality. Data Synthesis: All pooled analyses were based on a random effects model. Five cohort studies and 3 case control studies of patients with IBD on any immunosuppression with cervical high-grade dysplasia/cancer (n = 995) were included in the meta-analysis. The total IBD population in these studies was 77,116. The duration of follow up and time on immunosuppression was variable but ranged from 2 to 36 years. IBD patients had an increased risk of cervical high-grade dysplasia/cancer compared to healthy controls (OR = 1.34, 95% CI, 1.23–1.46). Heterogeneity was detected (I2 = 34.23, Q = 10.64, df = 7; P = 0.15). The source of this heterogeneity was found to be from the type of study, as well as the OR presented (crude versus adjusted). Limitations: There were few studies that met the inclusion criteria of comparing the rates of cervical high-grade dysplasia/cancer in patients with IBD on immunosuppressive medication compared to the rates of high-grade dysplasia and cancer in the general population. The heterogeneity within the studies is also a constraint of the results in the study. There is sufficient evidence to suggest there is an increased risk of cervical high-grade dysplasia/cancer in patients with IBD on immunosuppressive medications compared to the general population. Given this increased risk, increased screening intervals are indicated compared to the current screening guidelines for the general population.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,026 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,001 |
| Méta-épidémiologie (sens large) | 0,014 | 0,059 |
| Bibliométrie | 0,005 | 0,007 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,004 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».