Abstract C136: Cardiometabolic comorbidities and racial differences in cervical lesion development

Abstract Background: Despite progress in HPV vaccination rates, cervical cancer precursors such as high-grade squamous intraepithelial lesions (HSIL) remain a significant public health concern in the United States, with nearly 3 million women diagnosed with precancerous cervical lesions each year. Racial disparities persist in both the incidence and outcomes of cervical disease, particularly among Black and Latina women. Emerging evidence suggests that cardiometabolic conditions (e.g., diabetes, hypertension and high cholesterol) may play a role in the development and progression of HSIL, potentially contributing to these disparities. However, the extent and nature of these associations remain unclear. Objective: This study seeks to examine the association between cardiometabolic factors and the development of HSIL, with a specific focus on identifying racial differences in these relationships. Methods: Using a retrospective cohort design, we analyzed data from 2,189 women diagnosed with cervical intraepithelial neoplasia (grades 0–3) at the Virginia Commonwealth University Health System between 2014 and 2021. Multivariable logistic regression models were used to examine the association between cardiometabolic comorbidities (hypertension, high cholesterol, and diabetes) and the presence of HSIL, adjusting for relevant covariates. Results: Black women were significantly less likely than White women to present with HSIL (p = 0.0002). Diabetes was associated with a decreased risk of HSIL overall (p < .05). Stratified analysis revealed that Black women had higher rates of hypertension and high cholesterol, but Black women with both of these conditions did not show an increase in their risk of HSIL (p = 0.08). In contrast, White women with both hypertension and high cholesterol had a significantly higher risk of HSIL development (p = 0.02). Conclusions: These findings highlight that racial differences in comorbidity profiles may contribute to disparities in HSIL progression. Addressing chronic conditions, particularly hypertension and high cholesterol, may be essential for reducing cervical cancer risk among at-risk populations. Continued research is needed to clarify these relationships and to inform the development of prevention and treatment strategies that are responsive to the unique health profiles and needs of different racial groups. Citation Format: Shreya Balasani, Bianca Owens, Katherine Tossas. Cardiometabolic comorbidities and racial differences in cervical lesion development [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C136.