Cervical cancer incidence stratified by age in women living with HIV compared with the general population in the United States, 2002–2016

Details

• Alternative Title:
  AIDS
• Personal Author:
  STIER, Elizabeth A. ; ENGELS, Eric ; HORNER, Marie-Josèphe ; ROBINSON, William ; QIAO, Baozhen ; HAYES, Jennifer ; BAYAKLY, Rana ; ANDERSON, Bridget J. ; GONSALVES, Lou ; PAWLISH, Karen S. ; ZAVALA, Diego ; MONTEROSSO, Analise ; SHIELS, Meredith S.
• Description:
  Objective:
  
  Recommendations for the age of initiating screening for cervical cancer in women living with HIV (WLHIV) in the United States have not changed since 1995 when all women (regardless of immune status) were screened for cervical cancer from the age of onset of sexual activity, which often occurs in adolescence. By 2009, recognizing the lack of benefit as well as harms in screening young women, guidelines were revised to initiate cervical cancer screening for the general population at age 21. By comparing cervical cancer incidence in young WLHIV to that of the general population, we assessed the potential for increasing the recommended age of initiating cervical cancer screening in WLHIV.
  
  Design:
  
  We compared age-specific invasive cervical cancer (ICC) rates among WLHIV to the general population in the United States HIV/AIDS Cancer Match Study.
  
  Methods:
  
  We estimated standardized incidence ratios as the observed number of cervical cancer cases among WLHIV divided by the expected number, standardized to the general population by age, race/ethnicity, registry and calendar year.
  
  Results:
  
  ICC rates among WLHIV were elevated across all age groups between ages 25–54 (SIR=3.80; 95%CI 3.48, 4.15), but there were zero cases among ages <25.
  
  Conclusions:
  
  The absence of ICC among WLHIV <25 years supports initiating cervical cancer screening at age 21, rather than adolescence, to prevent cancers in WLHIV at ages with higher risk of ICC.
  
  
• Keywords:
  Adolescent Adult Cervical Cancer Incidence Cervical Cancer Prevention Early Detection Of Cancer Female HIV Infections Humans Incidence Mass Screening Middle Aged Screening Guidelines United States Uterine Cervical Neoplasms Women Living With HIV Young Adult

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• Source:
  AIDS. 35(11):1851-1856
• Pubmed ID:
  34049357
• Pubmed Central ID:
  PMC8373779
• Document Type:
  Journal Article
• Funding:
  U58 DP003931/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201800009C/CA/NCI NIH HHSUnited States/ ; U58 DP003875/DP/NCCDPHP CDC HHSUnited States/ ; U62 PS003960/PS/NCHHSTP CDC HHSUnited States/ ; U01 DP006302/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201300021C/CA/NCI NIH HHSUnited States/ ; U62 PS004001/PS/NCHHSTP CDC HHSUnited States/ ; U01DP006302/ACL/ACL HHSUnited States/ ; U62 PS004011/PS/NCHHSTP CDC HHSUnited States/ ; UM1 CA121947/CA/NCI NIH HHSUnited States/ ; U62 PS001005/PS/NCHHSTP CDC HHSUnited States/ ; U01 CA121947/CA/NCI NIH HHSUnited States/ ; HHSN261201800002C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009I/CA/NCI NIH HHSUnited States/ ; HHSN261201800002B/CA/NCI NIH HHSUnited States/ ; HHSN261201800007C/CA/NCI NIH HHSUnited States/
• Volume:
  35
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:850607f8ef5efb6a0f5f3342c7e3df0d50e43c355031bc1bffd0da5f99f11d75
• Download URL:
  https://stacks.cdc.gov/view/cdc/109329/cdc_109329_DS1.pdf
• File Type:
  [PDF - 543.95 KB ]