Cervical Dysplasia and Human Papillomavirus Infection in Rheumatoid Arthritis.

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DESCRIPTION (provided by applicant): I am a Rheumatologist and Postdoctoral Fellow in the Division of Pharmacoepidemiology and Pharmacoeconomics and the Division of Rheumatology, Immunology and Allergy at Brigham and Women's Hospital (BWH), undertaking a training in Pharmacoepidemiology in the rheumatic diseases under the guidance of Drs. Daniel H. Solomon and Sebastian Schneeweiss. My long term goal is to establish a career as an independent pharmacoepidemiology researcher with expertise in the safety of drugs used in the rheumatic diseases. Previous studies have suggested that women with immunocompromised conditions including systemic lupus erythematosus, systemic sclerosis and ulcerative colitis are at a greater risk for cervical dysplasia and human papillomavirus (HPV) infection than are women in the general population. However, scant data exist regarding the risk of cervical dysplasia and HPV infection in rheumatoid arthritis (RA). I propose to use several integrative approaches to evaluate the risk of cervical dysplasia, cervical cancer and HPV infection in patients with RA, to relate the risks of these outcomes to different types of immunosuppressive therapy (i.e., traditional disease-modifying anti-rheumatic drugs versus biologic therapy) as well as demographic and other clinical factors and to examine adherence to current cervical cancer screening guidelines in patients with RA. I will be using different data sources including electronic medical records, large administrative databases, patient survey, as well as patient registries. With the advent of the cervical cancer vaccine, identification of women at high risk carries great