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

Details

• Alternative Title:
  Int J Cancer
• Personal Author:
  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 ; Verbon, Annelies ; Vehreschild, Jörg Janne ; Post, Frank A. ; Sabin, Caroline ; Mocroft, Amanda ; Dronda, Fernando ; Obel, Niels ; Grabar, Sophie ; Spagnuolo, Vincenzo ; Quiros-Roldan, Eugenia ; Mussini, Cristina ; Miro, José M. ; Meyer, Laurence ; Hasse, Barbara ; Konopnicki, Deborah ; Roca, Bernardino ; Barger, Diana ; Clifford, Gary M. ; Franceschi, Silvia ; Egger, Matthias ; Bohlius, Julia
• Corporate Authors:
  for the AIDS-defining Cancer Project Working Group of IeDEA and COHERE in EuroCoord
• Description:
  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.
• Subjects:
  Adolescent Adult Age Factors Anti-Retroviral Agents CD4 Lymphocyte Count Cross-Cultural Comparison Early Detection Of Cancer Europe Female Follow-Up Studies Health Status Disparities HIV Infections Humans Incidence Latin America Middle Aged North America Risk Factors South Africa Uterine Cervical Neoplasms Young Adult

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• Keywords:
  Cervical Cancer Cohort Study HIV Incidence Rate
• Source:
  Int J Cancer. 146(3):601-609
• Pubmed ID:
  31215037
• Pubmed Central ID:
  PMC6898726
• Document Type:
  Journal Article
• Funding:
  R01 AA016893/AA/NIAAA NIH HHSUnited States/ ; P30AI036219/NH/NIH HHSUnited States/ ; P30 AI027767/AI/NIAID NIH HHSUnited States/ ; U01 AI035042/AI/NIAID NIH HHSUnited States/ ; U10EY008052/NH/NIH HHSUnited States/ ; P30 MH062246/MH/NIMH NIH HHSUnited States/ ; P30AI027767/NH/NIH HHSUnited States/ ; UL1TR000454/NH/NIH HHSUnited States/ ; U01 AI069434/AI/NIAID NIH HHSUnited States/ ; U01 AI037984/AI/NIAID NIH HHSUnited States/ ; U01 AI103397/AI/NIAID NIH HHSUnited States/ ; K23EY013707/NH/NIH HHSUnited States/ ; U01AI068634/NH/NIH HHSUnited States/ ; U01HD032632/NH/NIH HHSUnited States/ ; R01 DA011602/DA/NIDA NIH HHSUnited States/ ; K23 EY013707/EY/NEI NIH HHSUnited States/ ; U01AI103401/NH/NIH HHSUnited States/ ; U01AI069434/NH/NIH HHSUnited States/ ; R01 CA165937/CA/NCI NIH HHSUnited States/ ; U01AI034993/NH/NIH HHSUnited States/ ; U01AA020790/NH/NIH HHSUnited States/ ; UM1AI035043/NH/NIH HHSUnited States/ ; Z01CP010176/NH/NIH HHSUnited States/ ; U01 AI031834/AI/NIAID NIH HHSUnited States/ ; UL1TR000083/NH/NIH HHSUnited States/ ; K01AI093197/NH/NIH HHSUnited States/ ; U01AI103390/NH/NIH HHSUnited States/ ; P30 AI094189/AI/NIAID NIH HHSUnited States/ ; U01 AI035004/AI/NIAID NIH HHSUnited States/ ; UL1TR000004/NH/NIH HHSUnited States/ ; G12 MD007583/MD/NIMHD NIH HHSUnited States/ ; K24DA000432/NH/NIH HHSUnited States/ ; U01AI042590/NH/NIH HHSUnited States/ ; U01AI034989/NH/NIH HHSUnited States/ ; R01CA165937/NH/NIH HHSUnited States/ ; K24 DA000432/DA/NIDA NIH HHSUnited States/ ; M01RR000052/NH/NIH HHSUnited States/ ; K23 AI120875/AI/NIAID NIH HHSUnited States/ ; U01 DA036935/DA/NIDA NIH HHSUnited States/ ; U24AA020794/NH/NIH HHSUnited States/ ; G12MD007583/NH/NIH HHSUnited States/ ; U01 AI038855/AI/NIAID NIH HHSUnited States/ ; R01DA012568/NH/NIH HHSUnited States/ ; U54 MD007587/MD/NIMHD NIH HHSUnited States/ ; U01 AI069923/AI/NIAID NIH HHSUnited States/ ; U01AI038855/NH/NIH HHSUnited States/ ; U01 AI034989/AI/NIAID NIH HHSUnited States/ ; UL1 RR024131/RR/NCRR NIH HHSUnited States/ ; P30AI027763/NH/NIH HHSUnited States/ ; R01DA011602/NH/NIH HHSUnited States/ ; U01 AI037613/AI/NIAID NIH HHSUnited States/ ; U01AI069432/NH/NIH HHSUnited States/ ; K01AI131895/NH/NIH HHSUnited States/ ; K23AI120875/NH/NIH HHSUnited States/ ; UM1 AI068634/AI/NIAID NIH HHSUnited States/ ; U01AI069918/NH/NIH HHSUnited States/ ; U01 AI035041/AI/NIAID NIH HHSUnited States/ ; R24 AI067039/AI/NIAID NIH HHSUnited States/ ; N01CP01004/NH/NIH HHSUnited States/ ; U01AI031834/NH/NIH HHSUnited States/ ; UM1 AI035043/AI/NIAID NIH HHSUnited States/ ; U01 AI069432/AI/NIAID NIH HHSUnited States/ ; U01AA013566/NH/NIH HHSUnited States/ ; N02CP055504/NH/NIH HHSUnited States/ ; N02CP55504/CP/NCI NIH HHSUnited States/ ; U01 AI038858/AI/NIAID NIH HHSUnited States/ ; U01AI035040/NH/NIH HHSUnited States/ ; 90051652/HRSA/HRSA HHSUnited States/ ; KL2TR000421/NH/NIH HHSUnited States/ ; U10 EY008057/EY/NEI NIH HHSUnited States/ ; U01 AI068636/AI/NIAID NIH HHSUnited States/ ; U01 AI034994/AI/NIAID NIH HHSUnited States/ ; U10EY008067/NH/NIH HHSUnited States/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/ ; M01 RR000052/RR/NCRR NIH HHSUnited States/ ; P30MH62246/NH/NIH HHSUnited States/ ; UL1 TR000454/TR/NCATS NIH HHSUnited States/ ; U10 EY008052/EY/NEI NIH HHSUnited States/ ; U01AI038858/NH/NIH HHSUnited States/ ; U01AI103397/NH/NIH HHSUnited States/ ; U01AI034994/NH/NIH HHSUnited States/ ; U01AI035041/NH/NIH HHSUnited States/ ; U10EY008057/NH/NIH HHSUnited States/ ; U01 AA020790/AA/NIAAA NIH HHSUnited States/ ; P30 AI110527/AI/NIAID NIH HHSUnited States/ ; P30 AI027763/AI/NIAID NIH HHSUnited States/ ; K01 AI093197/AI/NIAID NIH HHSUnited States/ ; U01 AI069918/AI/NIAID NIH HHSUnited States/ ; K24 AI118591/AI/NIAID NIH HHSUnited States/ ; K24 AI065298/AI/NIAID NIH HHSUnited States/ ; U01 AI069907/AI/NIAID NIH HHSUnited States/ ; U01 AI103401/AI/NIAID NIH HHSUnited States/ ; U01 AA013566/AA/NIAAA NIH HHSUnited States/ ; P30AI110527/NH/NIH HHSUnited States/ ; CDC-200-2015-63931/CC/CDC HHSUnited States/ ; R24AI067039/NH/NIH HHSUnited States/ ; U01AI037613/NH/NIH HHSUnited States/ ; P30 AI027757/AI/NIAID NIH HHSUnited States/ ; P30AI027757/NH/NIH HHSUnited States/ ; UL1 TR000083/TR/NCATS NIH HHSUnited States/ ; R01 DA012568/DA/NIDA NIH HHSUnited States/ ; P30AI050410/NH/NIH HHSUnited States/ ; CDC-200-2006-18797/CC/CDC HHSUnited States/ ; U01AI103408/NH/NIH HHSUnited States/ ; U54MD007587/NH/NIH HHSUnited States/ ; P30AI094189/NH/NIH HHSUnited States/ ; U01 AI035040/AI/NIAID NIH HHSUnited States/ ; U01AI035004/NH/NIH HHSUnited States/ ; KL2 TR000421/TR/NCATS NIH HHSUnited States/ ; U01AI037984/NH/NIH HHSUnited States/ ; U01AI035042/NH/NIH HHSUnited States/ ; R01AA016893/NH/NIH HHSUnited States/ ; U01 AI034993/AI/NIAID NIH HHSUnited States/ ; K24AI118591/NH/NIH HHSUnited States/ ; K24AI065298/NH/NIH HHSUnited States/ ; UL1RR024131/NH/NIH HHSUnited States/ ; U01 AI103390/AI/NIAID NIH HHSUnited States/ ; Z01CP010214/NH/NIH HHSUnited States/ ; 001/WHO_/World Health OrganizationInternational/ ; UL1 TR000004/TR/NCATS NIH HHSUnited States/ ; U01 AI103408/AI/NIAID NIH HHSUnited States/ ; F31DA037788/NH/NIH HHSUnited States/ ; F31 DA037788/DA/NIDA NIH HHSUnited States/ ; U01 AI035039/AI/NIAID NIH HHSUnited States/ ; R01 AG053100/NH/NIH HHSUnited States/ ; U01DA036935/NH/NIH HHSUnited States/ ; MR/M004236/1/MRC_/Medical Research CouncilUnited Kingdom/ ; R01 AG053100/AG/NIA NIH HHSUnited States/ ; U10 EY008067/EY/NEI NIH HHSUnited States/ ; P30 AI036219/AI/NIAID NIH HHSUnited States/ ; Z01 CP010176/ImNIH/Intramural NIH HHSUnited States/ ; N02CP91027/NH/NIH HHSUnited States/ ; U01 AI069924/AI/NIAID NIH HHSUnited States/ ; U24 AA020794/AA/NIAAA NIH HHSUnited States/ ; U01DA03629/NH/NIH HHSUnited States/ ; U01AI068636/NH/NIH HHSUnited States/ ; U01 AI068634/AI/NIAID NIH HHSUnited States/ ; P30 AI050410/AI/NIAID NIH HHSUnited States/ ; U01AI035039/NH/NIH HHSUnited States/ ; U01 HD032632/HD/NICHD NIH HHSUnited States/ ; U01 AI042590/AI/NIAID NIH HHSUnited States/ ; F31AI124794/NH/NIH HHSUnited States/
• Volume:
  146
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ffe9d03a21eb1b925b8e0e3d0e9b4dfb0ba9e2771aece3cfca0355530ff71177
• Download URL:
  https://stacks.cdc.gov/view/cdc/83235/cdc_83235_DS1.pdf
• File Type:
  [PDF - 311.31 KB ]