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

By Eliane Rohner, Lukas Bütikofer, Kurt Schmidlin, Mazvita Sengayi  Dr Mhairi Maskew  Janet Giddy, Katayoun Taghavi, Richard D. Moore, James J. Goedert, M. John Gill, Michael J. Silverberg, Gypsyamber D’Souza, Pragna Patel, Jessica L. Castilho, Jeremy Ross, Annette Sohn, Firouze Bani-Sadr, Ninon Taylor, Vassilios Paparizos, Fabrice Bonnet, Annelies Verbon, Jörg Janne Vehreschild, Frank A. Post, Caroline Sabin, Amanda Mocroft, Fernando Dronda, Niels Obel, Sophie Grabar, Vincenzo Spagnuolo, Eugenia Quiros-Roldan, Cristina Mussini, José M. Miro, Laurence Meyer, Barbara Hasse, Deborah Konopnicki, Bernardino Roca, Diana Barger, Gary M. Clifford, Silvia Franceschi, Matthias Egger and Julia Bohlius  |  | 

Vast global inequities in the burden of invasive cervical cancer (ICC) exist. While access to effective screening and treatment of precancerous cervical lesions has substantially reduced the risk of developing ICC in high-income countries, ICC remains a common cause of premature mortality and morbidity in women in low- and middle-income countries. ICC disproportionally affects women living with human immunodeficiency virus (HIV), who are more likely to have persistent coinfection with high-risk human papillomavirus (HPV) types,3 to develop precancerous cervical lesions4 and to progress to ICC than HIV-negative women.4 The advent
and scale-up of combination antiretroviral therapy (ART) has led to a dramatic decline in morbidity and mortality from many HIV associated
diseases, 5 but these decreases have not occurred for ICC. Indeed, as life expectancy after starting ART increases, there is more time for precancerous cervical lesions to develop into ICC, but early initiation of ART seems to lower HPV coinfection rates and improve control of precancerous cervical lesions. Global inequities in ICC incidence rates among women living with HIV have not been assessed previously. Our aim was to assess such inequities by comparing ICC incidence rates across different geographic regions among women who had initiated ART. Additionally, we examined risk factors for developing ICC in these women.

Publication details

International Journal of Cancer