Cervical cancer risk in women living with HIV across four continents: A multicohort study.

Rohner, Eliane; Bütikofer, Lukas; Schmidlin, Kurt; Sengayi, Mazvita; Maskew, Mhairi; Giddy, Janet; Taghavi, Katayoun; Moore, Richard D; Goedert, James J; Gill, M John; Silverberg, Michael J; D'Souza, Gypsyamber; Patel, Pragna; Castilho, Jessica L; Ross, Jeremy; Sohn, Annette; Bani-Sadr, Firouze; Taylor, Ninon; Paparizos, Vassilios; Bonnet, Fabrice; ... (2019). Cervical cancer risk in women living with HIV across four continents: A multicohort study. (In Press). International journal of cancer Wiley-Blackwell 10.1002/ijc.32260

[img] Text
Rohner IntJCancer 2019_epub.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (825kB) | Request a copy
[img] Text
Rohner IntJCancer 2019_postprint.pdf - Accepted Version
Restricted to registered users only until 20 June 2020.
Available under License Publisher holds Copyright.

Download (1MB) | Request a copy

We compared invasive cervical cancer (ICC) incidence rates in Europe, South Africa, Latin and North America among women living with HIV who initiated antiretroviral therapy (ART) between 1996 and 2014. We analyzed cohort data from the International Epidemiology Databases to Evaluate AIDS (IeDEA) and the Collaboration of Observational HIV Epidemiological Research in Europe (COHERE) in EuroCoord. We used flexible parametric survival models to determine regional ICC rates and risk factors for incident ICC. We included 64,231 women from 45 countries. During 320,141 person-years (pys), 356 incident ICC cases were diagnosed (Europe 164, South Africa 156, North America 19 and Latin America 17). Raw ICC incidence rates per 100,000 pys were 447 in South Africa (95% confidence interval [CI]: 382-523), 136 in Latin America (95% CI: 85-219), 76 in North America (95% CI: 48-119) and 66 in Europe (95% CI: 57-77). Compared to European women ICC rates at 5 years after ART initiation were more than double in Latin America (adjusted hazard ratio [aHR]: 2.43, 95% CI: 1.27-4.68) and 11 times higher in South Africa (aHR: 10.66, 95% CI: 6.73-16.88), but similar in North America (aHR: 0.79, 95% CI: 0.37-1.71). Overall, ICC rates increased with age (>50 years vs. 16-30 years, aHR: 1.57, 95% CI: 1.03-2.40) and lower CD4 cell counts at ART initiation (per 100 cell/μl decrease, aHR: 1.25, 95% CI: 1.15-1.36). Improving access to early ART initiation and effective cervical cancer screening in women living with HIV should be key parts of global efforts to reduce cancer-related health inequities.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Rohner, Eliane; Bütikofer, Lukas; Schmidlin, Kurt; Taghavi, Katayoun; Egger, Matthias and Bohlius, Julia

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0020-7136

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Beatrice Minder Wyssmann

Date Deposited:

22 Jun 2019 09:33

Last Modified:

23 Oct 2019 03:50

Publisher DOI:

10.1002/ijc.32260

PubMed ID:

31215037

Uncontrolled Keywords:

HIV cervical cancer cohort study incidence rate

BORIS DOI:

10.7892/boris.131517

URI:

https://boris.unibe.ch/id/eprint/131517

Actions (login required)

Edit item Edit item
Provide Feedback