Cervical Cytological Abnormalities in Women with Inflammatory Bowel Disease (IBD) and Non-IBD Controls: A Retrospective Study

Background: Data on cervical cytological abnormalities in women with inflammatory bowel disease (IBD) are inconsistent. We compared their prevalence in women with and without IBD. Methods: In this retrospective single-centre analysis of electronic medical records (2022–2024), women with Crohn’s disease (CD) or ulcerative colitis (UC) were compared with 141 women treated at a gynaecology outpatient clinic. Cytology was classified exclusively using the Bethesda System (abnormal = ASC-US or worse; “Pap II” inflammation = normal). Results: Of 301 women with IBD, 280 (141 CD, 139 UC) had evaluable cytology. The most recent cytology assessment was abnormal in 4/280 women with IBD (1.4%) versus 13/141 controls (9.2%; OR 0.14, 95% CI 0.05–0.45); a current or historical abnormality was identified in 12/280 women with IBD (4.3%) versus 13/141 controls (9.2%; OR 0.44, 95% CI 0.20–0.99; p = 0.051). CD and UC did not differ, and no clinical or treatment variable was associated with abnormality (12 events). hrHPV testing was documented in 15.7% of women with IBD (controls 85.8%). Conclusions: Abnormal cytology was infrequent in this closely monitored IBD cohort and numerically lower than in controls; however, the controls comprised a selected group, HPV testing differed between groups, and events were few, so an increased risk cannot be excluded. Regular gynaecological surveillance remains essential.