P2922 - Examining Cervical Cancer Screening Practices in Liver Transplant Recipients: Lack of Organ Specific Guidelines and Socioeconomic Influences

Pavithra Ramakrishnan, MS, MD¹, Jacquelin Blomker, MD², Katherine Cooke, MD², Virginia Hsiao, BS², Jessica Makori, MS³, Claire Collins, BS², Mary McConville, BS², Jena Benson, ³, Katie McLaughlin, BA, JD², Rachel Vogel, PhD², Taylor Bowler, DO⁴, Deanna Teoh, MD², Elizabeth S. Aby, MD^2
1University of Minnesota, Eden Prairie, MN; ²University of Minnesota, Minneapolis, MN; ³University of Minnesota Medical School, Minneapolis, MN; ⁴University of Minnesota Medical Center, Minneapolis, MN

Introduction: Liver transplant (LT) recipients are at approximately 2 times higher risk of de novo cancer compared to the general population. The standardized incidence ratio of cervical cancer within the solid organ transplant (SOT) population is 1.1-30.7. American society of transplantation guidelines recommend screening renal transplant recipients with yearly pap smear testing and pelvic exam. Using this guidance, our study aims to assess guideline concordance and impact of socio economic parameters on access to cervical cancer screening.

Methods: Female patients aged 18-75 with intact uterus and cervix who underwent LT between 2015-2021 at the University of Minnesota were included. Demographic, socio economic, clinical and pre-LT cervical cancer screening information was collected. Of a total of 557 patients, 134 met our inclusion criteria. Comparisons between categorical variables were done using chi square or Fisher’s exact test. The Wilcox rank-sum test was used for continuous variables.

Results: 134 adult females were included. 51.4 % (n=69) of the LT recipients with an intact cervix underwent some form of cervical cancer screening post-transplant. Unscreened populations were significantly more likely to be older (57.6 vs 54 years, p=0.03), identified as American Indian or Alaskan Native (7.7% vs 0% p=0.003) and did not live in Minnesota ***. Patients with a diagnosis of Hepatocellular carcinoma (73.9% vs 88.4% p=0.03) and previous abnormal cervical cancer screening results were more likely to be screened (12.3% vs 29% p=0.02). No differences were observed in other racial, ethnic, medical, financial or neighborhood deprivation parameters (Table 1).

Discussion: Current practice for cervical cancer screening within the SOT population is extrapolated from the general population. Aside from renal transplant, there is minimal research exploring the effectiveness of current guidelines based on cancer incidence, cost effectiveness, and risk benefit analysis. Our study bridges this knowledge gap. Among the LT transplant recipients, nearly half the population had not received appropriate screening. Older age, lack of previous cervical pathology or other cancer history, and being American Indian or Alaskan Native were identified as risk factors for lack of screening. More research is needed to assess incidence rates of cervical cancer among LT patients to better inform organ specific screening guidelines.


Disclosures:


Pavithra Ramakrishnan, MS, MD¹, Jacquelin Blomker, MD², Katherine Cooke, MD², Virginia Hsiao, BS², Jessica Makori, MS³, Claire Collins, BS², Mary McConville, BS², Jena Benson, ³, Katie McLaughlin, BA, JD², Rachel Vogel, PhD², Taylor Bowler, DO⁴, Deanna Teoh, MD², Elizabeth S. Aby, MD². P2922 - Examining Cervical Cancer Screening Practices in Liver Transplant Recipients: Lack of Organ Specific Guidelines and Socioeconomic Influences, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.