1
|
Turdo YQ, Ruffieux Y, Boshomane TM, Mouton H, Taghavi K, Haas AD, Egger M, Maartens G, Rohner E. Cancer treatment and survival among cervical cancer patients living with or without HIV in South Africa. Gynecol Oncol Rep 2022; 43:101069. [PMID: 36185101 PMCID: PMC9516451 DOI: 10.1016/j.gore.2022.101069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 11/24/2022] Open
Abstract
Analysis of cervical cancer treatment and survival by HIV status using reimbursement claims data from South Africa. HIV-positive patients were more likely to receive radio- and chemotherapy and less likely to undergo surgery. HIV-positive cervical cancer patients were at higher risk of death from all causes than HIV-negative patients.
Objective To compare cancer treatment and all-cause mortality between HIV-positive and HIV-negative cervical cancer patients in South Africa. Methods We assessed cancer treatment and all-cause mortality in HIV-positive and HIV-negative cervical cancer patients who received cancer treatment within 180 days of diagnosis using reimbursement claims data from a private medical insurance scheme in South Africa between 01/2011 and 07/2020. We assessed treatment provision using logistic regression and factors associated with all-cause mortality using Cox regression. We assigned missing values for histology and ethnicity using multiple imputation. Results Of 483 included women, 136 (28 %) were HIV-positive at cancer diagnosis (median age: 45.7 years), and 347 (72 %) were HIV-negative (median age: 54.1 years). Among 285 patients with available ICD-O-3 morphology claims codes, the proportion with cervical adenocarcinoma was substantially lower in HIV-positive (4 %) than in HIV-negative patients (26 %). Most HIV-positive patients (67 %) were on antiretroviral therapy at cancer diagnosis. HIV-positive patients were more likely to receive radiotherapy (adjusted odds ratio [aOR] 1.90, 95 % confidence interval [CI] 1.05–3.45) or chemotherapy (aOR 2.02, 95 %CI 0.92–4.43) and less likely to undergo surgery (aOR 0.53, 95 %CI 0.31–0.90) than HIV-negative patients. HIV-positive patients were at a higher risk of death from all causes than HIV-negative patients (adjusted hazard ratio 1.52, 95 %CI 1.06–2.19). Other factors associated with higher all-cause mortality included age > 60 years and metastases at diagnosis. Conclusions HIV-positive cervical cancer patients in South Africa had higher all-cause mortality than HIV-negative patients which could be explained by differences in tumour progression, clinical care, and HIV-specific mortality.
Collapse
|
2
|
Ramogola-Masire D, Grover S, Mathoma A, Monare B, Gabaitiri L, Bazzett-Matabele L, Hofmeyr GJ, Morroni C, Luckett R. Support for lowering cervical cancer screening age to 25 for women living with HIV: retrospective cross-sectional programmatic data from Botswana. BMC Womens Health 2022; 22:100. [PMID: 35366863 PMCID: PMC8976959 DOI: 10.1186/s12905-022-01680-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 03/21/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Women living with human immunodeficiency virus (HIV) tend to develop cervical cancer at a younger age than women without HIV. The World Health Organization's (WHO) 2021 guidelines for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention include a conditional recommendation for initiating screening at age 25 for women living with HIV (WLWH). This recommendation is based on low-certainty evidence, and WHO calls for additional data. We describe the association of age and HIV status with visual inspection with acetic acid (VIA) positivity and cervical intraepithelial neoplasia grade two or higher (CIN2+) in Botswana. METHODS This was a retrospective cross-sectional study of 5714 participants aged 25 to 49 years who underwent VIA screening in a clinic mainly serving WLWH. VIA-positive women received cryotherapy if eligible or were referred for colposcopy and excisional treatment. Known cervical cancer risk factors, screening outcome, and histological results were extracted from the program database. We compared the proportions and association of VIA positivity and CIN2+ by age and HIV status. RESULTS The median age was 35 years [IQR 31-39], and 18% of the women were aged 25-29. Ninety percent were WLWH; median CD4 count was 250 cells/µL [IQR 150-428], and 34.2% were on anti-retroviral treatment (ART). VIA-positivity was associated with younger age (OR 1.48, CI 1.28, 1.72 for 25-29 years vs. 30-49 years), and HIV-positivity (OR 1.85, CI 1.51, 2.28). CIN2+ was only associated with HIV-positivity (OR 6.12, CI 3.39, 11.10), and proportions of CIN2+ were similar for both age groups in WLWH (69.1% vs. 68.3%). CONCLUSIONS Younger WLWH in Botswana had a significant burden of CIN2+. This finding further supports lowering the screening age for WLWH from 30 to 25.
Collapse
Affiliation(s)
- Doreen Ramogola-Masire
- grid.7621.20000 0004 0635 5486Department of Obstetrics and Gynecology and Office of Research and Graduate Studies, University of Botswana, Corner of Notwane and Mabuto Road, Gaborone, Botswana
| | - Surbhi Grover
- grid.25879.310000 0004 1936 8972Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA ,Botswana U-Penn Partnership, Gaborone, Botswana
| | - Anikie Mathoma
- grid.7621.20000 0004 0635 5486Office of Research, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | | | - Lesego Gabaitiri
- grid.7621.20000 0004 0635 5486Department of Statistics, Faculty of Social Sciences, University of Botswana, Gaborone, Botswana
| | - Lisa Bazzett-Matabele
- grid.7621.20000 0004 0635 5486Department of Obstetrics and Gynecology and Office of Research and Graduate Studies, University of Botswana, Corner of Notwane and Mabuto Road, Gaborone, Botswana
| | - GJustus Hofmeyr
- grid.7621.20000 0004 0635 5486Department of Obstetrics and Gynecology and Office of Research and Graduate Studies, University of Botswana, Corner of Notwane and Mabuto Road, Gaborone, Botswana
| | - Chelsea Morroni
- grid.462829.3Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana ,grid.4305.20000 0004 1936 7988MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Rebecca Luckett
- grid.7621.20000 0004 0635 5486Department of Obstetrics and Gynecology and Office of Research and Graduate Studies, University of Botswana, Corner of Notwane and Mabuto Road, Gaborone, Botswana ,grid.462829.3Botswana-Harvard AIDS Institute Partnership, Gaborone, Botswana ,grid.239395.70000 0000 9011 8547Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA USA
| |
Collapse
|
3
|
Chaussade H, Le Marec F, Coureau G, Leleux O, Neau D, Lazaro E, Amadeo B, Duffau P, Ferrand H, Courtault C, Foucan AS, Wittkop L, Bonnet F. Incidence of lung and human papilloma virus-associated malignancies in HIV-infected patients. AIDS 2022; 36:665-673. [PMID: 34923517 DOI: 10.1097/qad.0000000000003152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Cancers represent one of the leading cause of mortality/morbidity in patients with HIV (PWH) in industrialized countries. The objective of our study was to compare incidence of lung and human papilloma virus (HPV)-related cancers among PWH with general population over the 2010-2017 period. DESIGN Prospective and multicenter cohort study. METHODS The study included patients with lung and HPV-related cancers from the ANRS CO3 Aquitaine cohort (PWH) and the general population-based cancer registry in Gironde area. We calculated incidence rates for 100 000 person-years and incidence rate ratios (IRR). RESULTS Among the 3572 PWH, 70 cancers were diagnosed in 68 patients including 35 lung and 35 HPV-related cancers (18 oropharyngeal, 11 anal, 6 cervix). Incidence rates of lung and HPV-related-cancers were 311.1 in PWH and 209.8 in general population for 100 000 person-years, respectively. IRR were significantly increased in PWH for lung 1.8 [1.4-2.2] and HPV-related cancer 1.3 [1.0-1.6] and particularly high for patients between 40 and 49 years old [IRR 4.4 (2.3-8.4) for lung cancer and 3.7 (2.1-6.5) for HPV-related cancer]. CONCLUSION We emphasized the persistent high risk of lung and HPV-related cancer despite advent of antiretroviral therapies, particularly in the age strata of 40-49 years. Screening procedures should take into account this finding.
Collapse
Affiliation(s)
- Hélène Chaussade
- CHU Bordeaux, Services de médecine interne et maladies infectieuses
| | - Fabien Le Marec
- University Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3Eus
| | - Gaëlle Coureau
- Registre général des cancers de la Gironde, University of Bordeaux, Inserm Population Health Research Centre, Epicene Team, UMR 1219
| | - Olivier Leleux
- University Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3Eus
| | - Didier Neau
- CHU Bordeaux, Service des maladies infectieuses et tropicales, Bordeaux
| | - Estibaliz Lazaro
- CHU Bordeaux, Services de médecine interne et maladies infectieuses, Pessac
| | - Brice Amadeo
- Registre général des cancers de la Gironde, University of Bordeaux, Inserm Population Health Research Centre, Epicene Team, UMR 1219
| | - Pierre Duffau
- CHU Bordeaux, Services de médecine interne et maladies infectieuses
| | | | - Carine Courtault
- Service de médecine interne et maladies infectieuses, Arcachon, France
| | - Anne-Sophie Foucan
- Registre général des cancers de la Gironde, University of Bordeaux, Inserm Population Health Research Centre, Epicene Team, UMR 1219
| | - Linda Wittkop
- University Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3Eus
| | - Fabrice Bonnet
- CHU Bordeaux, Services de médecine interne et maladies infectieuses
- University Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, team MORPH3Eus
| |
Collapse
|
4
|
Rojas Rojas T, Poizot-Martin I, Rey D, Duvivier C, Bani-Sadr F, Cabie A, Delobel P, Jacomet C, Allavena C, Ferry T, Pugliese P, Valantin MA, Lamaury I, Hustache-Matthieu L, Fresard A, Houyou T, Huleux T, Cheret A, Makinson A, Obry-Roguet V, Lions C, Carrieri MP, Protopopescu C. Incidence of cervical, breast and colorectal cancers between 2010 and 2015 in people living with HIV in France. PLoS One 2022; 17:e0261069. [PMID: 35333883 PMCID: PMC8956191 DOI: 10.1371/journal.pone.0261069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 11/23/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND We aimed to evaluate the incidence rates between 2010 and 2015 for invasive cervical cancer (ICC), breast cancer (BC), and colorectal cancer (CRC) in people living with HIV (PLWH) in France, and to compare them with those in the French general population. These cancers are targeted by the national cancer-screening program. SETTING This is a retrospective study based on the longitudinal data of the French Dat'AIDS cohort. METHODS Standardized incidence ratios (SIR) for ICC and BC, and incidence rates for all three cancers were calculated overall and for specific sub-populations according to nadir CD4 cell count, HIV transmission category, HIV diagnosis period, and HCV coinfection. RESULTS The 2010-2015 CRC incidence rate was 25.0 [95% confidence interval (CI): 18.6-33.4] per 100,000 person-years, in 44,642 PLWH (both men and women). Compared with the general population, the ICC incidence rate was significantly higher in HIV-infected women both overall (SIR = 1.93, 95% CI: 1.18-3.14) and in the following sub-populations: nadir CD4 ≤ 200 cells/mm3 (SIR = 2.62, 95% CI: 1.45-4.74), HIV transmission through intravenous drug use (SIR = 5.14, 95% CI: 1.93-13.70), HCV coinfection (SIR = 3.52, 95% CI: 1.47-8.47) and HIV diagnosis before 2000 (SIR = 2.06, 95% CI: 1.07-3.97). Conversely, the BC incidence rate was significantly lower in the study sample than in the general population (SIR = 0.56, 95% CI: 0.42-0.73). CONCLUSION The present study showed no significant linear trend between 2010 and 2015 in the incidence rates of the three cancers explored in the PLWH study sample. Specific recommendations for ICC screening are still required for HIV-infected women and should focus on sub-populations at greatest risk.
Collapse
Affiliation(s)
- Teresa Rojas Rojas
- Aix-Marseille Univ, APHM Sainte-Marguerite, Clinical Immuno-Hematological Unit Marseille, Marseille, France
| | - Isabelle Poizot-Martin
- Aix-Marseille Univ, APHM Sainte-Marguerite, Clinical Immuno-Hematological Unit Marseille, Marseille, France
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
| | - David Rey
- Le Trait d’Union, HIV-Infection Care Center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Claudine Duvivier
- APHP-Hôpital Necker-Enfants Malades, Service de Maladies Infectieuses et Tropicales, Centre d’Infectiologie Necker-Pasteur, IHU Imagine, Paris, France
- Institut Cochin—CNRS 8104—INSERM U1016—RIL Team: Retrovirus, Infection and Latency, Université de Paris, Paris, France
- Centre Médical de l’Institut Pasteur, Institut Pasteur, Paris, France
| | - Firouzé Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - André Cabie
- Université des Antilles, CHU de Martinique, Fort-de-France, Martinique, France
| | - Pierre Delobel
- CHU de Toulouse, Service des Maladies Infectieuses et Tropicales-INSERM, UMR 1043- Université Toulouse III Paul Sabatier, Toulouse, France
| | - Christine Jacomet
- Clermont-Ferrand University Hospital Infectious and Tropical disease Department, Clermont Ferrand, France
| | - Clotilde Allavena
- Infectious Diseases Department, CHU Hôtel-Dieu, INSERM UIC 1413, CHU Nantes, Nantes, France
| | - Tristan Ferry
- Service de Maladies Infectieuses, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France
| | | | - Marc-Antoine Valantin
- GHPS Pitié Salpêtrière APHP, Infectious Diseases, Paris, France
- Sorbonne Universités UPMC Université Paris 6-INSERM-IPLESP, Paris, France
| | - Isabelle Lamaury
- Department of Infectious and Tropical Diseases, University Hospital of Pointe-à-Pitre, Pointe-à-Pitre, France
| | | | - Anne Fresard
- Department of Infectious and Tropical Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Tamazighth Houyou
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
- ORS PACA, Observatoire Régional De La Santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Thomas Huleux
- Service Universitaire des Maladies Infectieuses et du Voyageur—Centre Hospitalier G. DRON Tourcoing, Tourcoing, France
| | - Antoine Cheret
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Department of Internal Medicine, Bicêtre Hospital, AP-HP, Le Kremlin-Bicêtre, France
| | - Alain Makinson
- Department of Infectious Diseases, Montpellier University Hospital, INSERM U1175/IRD UMI 233, Montpellier, France
| | - Véronique Obry-Roguet
- Aix-Marseille Univ, APHM Sainte-Marguerite, Clinical Immuno-Hematological Unit Marseille, Marseille, France
| | - Caroline Lions
- Aix-Marseille Univ, APHM Sainte-Marguerite, Clinical Immuno-Hematological Unit Marseille, Marseille, France
| | - Maria Patrizia Carrieri
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
- ORS PACA, Observatoire Régional De La Santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Camelia Protopopescu
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l’Information Médicale, ISSPAM, Marseille, France
- ORS PACA, Observatoire Régional De La Santé Provence-Alpes-Côte d’Azur, Marseille, France
| | | |
Collapse
|
5
|
Poizot-Martin I, Lions C, Allavena C, Huleux T, Bani-Sadr F, Cheret A, Rey D, Duvivier C, Jacomet C, Ferry T, Cabie A, Fresard A, Pugliese P, Delobel P, Lamaury I, Chirouze C, Zaegel-Faucher O, Brégigeon S, Rojas Rojas T, Obry-Roguet V, Makinson A. Spectrum and Incidence Trends of AIDS- and Non-AIDS-Defining Cancers between 2010 and 2015 in the French Dat'AIDS Cohort. Cancer Epidemiol Biomarkers Prev 2020; 30:554-563. [PMID: 33310788 DOI: 10.1158/1055-9965.epi-20-1045] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/22/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cancer risk is higher in people living with HIV (PLWH) compared with the general population, and cancers related to age are expected to be most prevalent. METHODS We determined the spectrum and incidence rates of AIDS-defining cancers (ADC) and non-AIDS-defining cancers (NADC) and of lung, Hodgkin lymphoma (HL), head and neck (HNC), colon-rectum, anal, liver, breast, prostate, and urinary bladder cancers between January 2010 and December 2015 in the French Dat'AIDS cohort. Incidence rates were calculated by year and compared using the χ 2 test for linear trend. Standardized incidence ratios [SIR (95% confidence interval)] were calculated relative to the French general population. RESULTS Among 44,642 patients, corresponding to 180,216.4 person-years (PY), 1,440 cancer cases occurred in 1,314 patients. ADC incidence was 191.4 (172.3-212.7)/105 PY and declined over time overall and in men, whereas NADC incidence was higher [548.8 (515.6-584.1)/105 PY] and did not change. In men, non-Hodgkin lymphoma was the most common cancer, but prostate cancer had the highest incidence among NADCs. Breast cancer was the most common cancer in women. SIRs were higher for cervical cancer [1.93 (1.18-3.14)], HNC in women [2.4 (1.4-4.2)], liver [overall: 3.8 (3.1-4.6); men: 3.2 (2.5-4.0); women: 12.9 (8.3-20.0)], and HL [overall: 13.8 (11.1-17.1); men: 16.2 (12.9-20.4); women: 6.2 (3.22-11.9)] but lower for lung [overall: 0.7 (0.6-0.9); men: 0.7 (0.5-0.8)], prostate [0.6 (0.5-0.7)], and breast cancers [0.6 (0.4-0.7)]. CONCLUSIONS Spectrum of NADCs has changed, with prostate and breast cancers becoming the most common despite their lower SIR. IMPACT These results confirm the need to maintain regular epidemiologic cancer monitoring in order to update screening guidelines.
Collapse
Affiliation(s)
- Isabelle Poizot-Martin
- Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, APHM Sainte-Marguerite, Service d'immuno-Hématologie Clinique, Marseille, France. .,Aix-Marseille Université, APHM Sainte-Marguerite, Service d'immuno-hématologie Clinique, Marseille, France
| | - Caroline Lions
- Aix-Marseille Université, APHM Sainte-Marguerite, Service d'immuno-hématologie Clinique, Marseille, France
| | - Clotilde Allavena
- Service des Maladies Infectieuses et Tropicales, CHU Hôtel-Dieu, Nantes, France
| | - Thomas Huleux
- Service Universitaire des Maladies Infectieuses et du Voyageur - Centre Hospitalier G. DRON Tourcoing, Tourcoing, France
| | - Firouze Bani-Sadr
- Département de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Hôpital Robert Debré, Centre Hospitalier Universitaire, Reims, France
| | - Antoine Cheret
- Université Paris Descartes, Sorbonne Paris Cité, EA7327, Paris, Service de Médecine Interne - Immunologie Clinique - Hôpital Bicêtre - AP-HP, Le Kremlin-Bicêtre, France
| | - David Rey
- Le Trait d'Union, Centre de Soins de l'infection par le VIH, Hôpitaux Universitaires, Strasbourg, France
| | - Claudine Duvivier
- APHP-Hôpital Necker-Enfants Malades, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Paris, France, IHU Imagine, Paris, France.,Institut Cochin - CNRS 8104 - INSERM U1016 - RIL Team: Retrovirus, Infection and Latency, Université de Paris, Paris, France.,Institut Pasteur, Centre Médical de l'Institut Pasteur, Paris, France
| | - Christine Jacomet
- Centre Hospitalier Universitaire de Clermont-Ferrand, Département des Maladies Infectieuses et Tropicales, Clermont-Ferrand, France
| | - Tristan Ferry
- Service de Maladies Infectieuses, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - André Cabie
- CHU de Martinique, Fort-de-France, Université des Antilles, EA4537, Fort-de-France, Inserm CIC1424, CHU de Martinique, Fort-de-France, France
| | - Anne Fresard
- Centre Hospitalier Universitaire de Saint-Étienne, Département des Maladies Infectieuses et Tropicales, Saint-Etienne, France
| | | | - Pierre Delobel
- CHU de Toulouse, Service des Maladies Infectieuses et Tropicales, INSERM, UMR1043, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Isabelle Lamaury
- Département d'Infectiologie, Dermatologie et Immunologie Clinique, CHU Guadeloupe BP 465, Pointe-à-Pitre Cedex, France
| | - Catherine Chirouze
- Centre Hospitalier Régional Universitaire Hôpital Jean Minjoz, Département des Maladies Infectieuses et Tropicales, Besançon, France
| | - Olivia Zaegel-Faucher
- Aix-Marseille Université, APHM Sainte-Marguerite, Service d'immuno-hématologie Clinique, Marseille, France
| | - Sylvie Brégigeon
- Aix-Marseille Université, APHM Sainte-Marguerite, Service d'immuno-hématologie Clinique, Marseille, France
| | - Teresa Rojas Rojas
- Aix-Marseille Université, APHM Sainte-Marguerite, Service d'immuno-hématologie Clinique, Marseille, France
| | - Véronique Obry-Roguet
- Aix-Marseille Université, APHM Sainte-Marguerite, Service d'immuno-hématologie Clinique, Marseille, France
| | - Alain Makinson
- Centre Hospitalier Universitaire de Montpellier, Département des Maladies Infectieuses et Tropicales, INSERM U1175/IRD UMI 233, Montpellier, France
| |
Collapse
|
6
|
A prognostic study of patients with cervical cancer and HIV/AIDS in Bangkok, Thailand. Gynecol Oncol Rep 2020; 34:100669. [PMID: 33251314 PMCID: PMC7680700 DOI: 10.1016/j.gore.2020.100669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/05/2020] [Accepted: 10/27/2020] [Indexed: 01/22/2023] Open
Abstract
Favorable prognostic factors were a civil servant medical benefit plan and higher education. Advanced disease was a significant prognostic factor for shorter survival. HIV/AIDS status was not a significant prognostic factor for longer survival.
Cervical cancer is one of the most common cancers of women. In Thailand, the incidence and death rate of cervical cancer are 18.1 and 5.7 per 100,000 women, respectively. Disease progresses faster in patients infected with human immunodeficiency virus (HIV) with acquired immune deficiency syndrome (AIDS). However, limited data are available for Thailand. Here we determined the prevalence of HIV/AIDS and identified factors affecting survival. We reviewed medical records of women infected with HIV with cervical cancer treated at Ramathibodi Hospital from 2007 through 2014. Demographic and clinical data were collected upon diagnosis. We used the Kaplan–Meier method and a Cox proportional hazards model to evaluate the association of overall survival (OS) with risk factors. The mean, median and range of ages at diagnosis of the 1,362 subjects were 53.9 years, 53.0 years and 20–94 years, respectively. The prevalence of HIV/AIDS in patients with cervical cancer was 2.3% and 5-year survival was 61.2%. Multivariable analysis revealed that favourable prognostic factors were a civil servant medical benefit plan and higher education. Advanced cervical cancer was a poor prognostic factor. Prognosis of women with stage III and IV cervical cancer was extremely poor (HR = 7.25 (95%CI: 4.39–11.98)) in stage III and HR = 20.57 (95%CI: 11.59–36.53) in stage IV). The 1-, 3-, and 5-year survival rates of patients with (74.2%, 67.6%, and 63.6%, respectively) or without (87.4%, 71.3% and 63.7%, respectively) HIV/AIDS were not significantly different.
Collapse
|