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Human papillomavirus (HPV) and cervical dysplasia in adult female cystic fibrosis (CF) lung transplant recipients
  1. Christina Thornton1,
  2. Ranjani Somayaji1,2,3,
  3. Angel Chu1,2,
  4. Michael D Parkins1,2
  1. 1Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  2. 2Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
  3. 3Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
  1. Correspondence to Dr Michael D Parkins, Medicine, University of Calgary Cumming School of Medicine, Calgary, AB T2N 1N4, Canada; mdparkin{at}


Human papillomavirus (HPV) is the principal risk factor for cervical cancer. Transplant recipients are at a disproportionate risk of HPV complications. We conducted a single-centre, retrospective study of adult female cystic fibrosis (CF) lung transplant recipients between 2008 and 2021. We observed 12 of 34 (35.3%) with ≥1 abnormal pap smear (median age: 26.7 years). Complications included refractory anogenital warts (n=3), vulvectomy (n=2) and cervical cancer (n=4), with two deaths from metastatic disease. None with HPV morbidity was vaccinated. Lung transplant recipients had greater odds of cervical dysplasia relative to controls (OR, 3.98; 95% CI 1.17 to 11.82). CF care providers must prioritise HPV vaccination to attenuate potential future morbidity and mortality.

  • cystic fibrosis
  • lung transplantation
  • immunodeficiency

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  • Contributors CT performed clinical chart reviews and collected the relevant data. RS assisted in statistical calculations. AC provided guidance related to the relevant literature in the area. MDP envisioned and supervised the project and serves as its guarantor. CT created the first draft of the manuscript, and all authors assisted in the creation of the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests CT is supported by a Cystic Fibrosis Foundation Fellowship. RS has no conflicts relevant to this work but serves on Cystic Fibrosis Foundation and Cystic Fibrosis Canada advisory committees. AC has worked with Merck in an advisory capacity and serves an advisory role for Immunize Canada. MDP has no conflicts relevant to this work but serves as Vice Chair for Cystic Fibrosis Canada’s Research Advisory Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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