Title: Gynecological comorbidities and management in women with chronic pathologies or in oncological settings
Date : November 28, 2023 at 3:30 p.m.
Location : Faculté de médecine Lyon Est, Bâtiment Principal Rockefeller, en salle des Thèses.
Jury :
M. CARCOPINO Xavier, Professeur des Universités Praticien Hospitalier, Université AixMarseille ;
Madame CATTEAU-JONARD Sophie, Professeure des Universités Praticien Hospitalier, Université de Lille ;
Madame CHRISTIN-MAITRE Sophie, Professeure des Universités Praticien Hospitalier, Sorbonne Université Paris ;
M. GOLFIER François, Professeur des Universités Praticien Hospitalier, Université Lyon 1
Mme PLU-BUREAU Geneviève, Professeure des Universités Praticien Hospitalier, Université Paris Descartes ;
Mme RAY-COQUARD Isabelle, Professeure des Universités Praticien Hospitalier, Université Lyon 1 ;
M. SALLE Bruno, Professeur des Universités Praticien Hospitalier, Université Lyon 1.
Abstract :
The first part of the thesis concerned gynecological care for women with cystic fibrosis. An initial cross-sectional descriptive study, carried out at the Lyon cystic fibrosis resource and competence center (CRCM), highlighted inadequate gynecological care (follow-up, contraceptive coverage and cervical screening) (14).
A second study assessed the impact of a gynecological consultation service on the CRCM site two years after its introduction, with a significant improvement in care (according to the same three indicators) (32). A didactic publication helped raise awareness among healthcare professionals of the importance of gynecological follow-up for this population, and its particularities (24).
The second aspect of the thesis was the search for gynecological comorbidities specific to cystic fibrosis. An initial retrospective study revealed a high frequency of papillomavirus (HPV)-related cervical pathology (in both transplanted and non-transplanted women) (20). Thanks to funding (Vaincre la Mucoviscidose, 2016), a prospective study was then conducted, and confirmed an excess risk (publication under review in the Journal of Cystic Fibrosis). The epidemiological link between cystic fibrosis and cervical pathology is also still being assessed by means of a nationwide study crossing data from the Système National des Données de Santé and the French Cystic Fibrosis Registry (drafting the protocol, obtaining Ligue contre le Cancer funding and taking regulatory steps as part of the thesis work) (55).
The third part of the thesis concerned the prevention of HPV-related pathologies through vaccination. Thanks to funding from the Grégory Lemarchal association, a national multicentric study was carried out to assess HPV vaccination coverage and the obstacles to vaccination (38).
