Sexual health issues after lung transplantation: importance of cervical screening

To determine the incidence and outcomes of human papillomavirus infection and cervical abnormalities after lung transplantation, we performed a retrospective cross-sectional study of all 166 female recipients who underwent transplantation between February 1989 and June 2001 at our institution. The incidence of low-grade epithelial abnormality of the cervix, cervical intra-epithelial neoplasia (CIN) 1, and the earliest pre-cancerous changes of the cervical epithelial cells, CIN 3, in the post-transplant cohort was 42.2 and 30, respectively, per 1000 women screened compared with 8.3 and 6.2 per 1000 women screened (20-69 years old) in a large reference population. We conclude that the incidence of cervical abnormalities in lung transplant recipients is significantly greater than in the general population. The importance of regular surveillance in immunosuppressed patients to decrease the burden of disease from this potentially fatal but treatable condition is emphasized.