Rohner, Eliane ORCID: 0000-0002-0554-2875, Butikofer, Lukas ORCID: 0000-0002-0801-746X, Schmidlin, Kurt ORCID: 0000-0003-0486-4490, 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, Jorg Janne, Post, Frank A., Sabin, Caroline, Mocroft, Amanda, Dronda, Fernando, Obel, Niels, Grabar, Sophie, Spagnuolo, Vincenzo, Quiros-Roldan, Eugenia, Mussini, Cristina, Miro, Jose M., Meyer, Laurence, Hasse, Barbara, Konopnicki, Deborah, Roca, Bernardino, Barger, Diana, Clifford, Gary M., Franceschi, Silvia, Egger, Matthias and Bohlius, Julia (2020). Cervical cancer risk in women living with HIV across four continents: A multicohort study. Int. J. Cancer, 146 (3). S. 601 - 610. HOBOKEN: WILEY. ISSN 1097-0215

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Abstract

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/mu l 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. What's new? Invasive cervical cancer (ICC) is a significant burden among women living with human immunodeficiency virus (HIV). Little is known, however, about geographical differences in ICC rates in women living with HIV. Here, ICC incidence rates in women who received antiretroviral therapy (ART) were compared across geographic regions. ICC incidence was notably high among women living with HIV in South Africa and Latin America. Five years after ART initiation, ICC incidence remained elevated for women in these two regions, compared with women in Europe and North America. Reduced CD4 cell count and older age at ART initiation were associated with increased ICC risk.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Rohner, ElianeUNSPECIFIEDorcid.org/0000-0002-0554-2875UNSPECIFIED
Butikofer, LukasUNSPECIFIEDorcid.org/0000-0002-0801-746XUNSPECIFIED
Schmidlin, KurtUNSPECIFIEDorcid.org/0000-0003-0486-4490UNSPECIFIED
Sengayi, MazvitaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maskew, MhairiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Giddy, JanetUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Taghavi, KatayounUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moore, Richard D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goedert, James J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gill, M. JohnUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Silverberg, Michael J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
D'Souza, GypsyamberUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Patel, PragnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Castilho, Jessica L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ross, JeremyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sohn, AnnetteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bani-Sadr, FirouzeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Taylor, NinonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paparizos, VassiliosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bonnet, FabriceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Verbon, AnneliesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vehreschild, Jorg JanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Post, Frank A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sabin, CarolineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mocroft, AmandaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dronda, FernandoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Obel, NielsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grabar, SophieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spagnuolo, VincenzoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Quiros-Roldan, EugeniaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mussini, CristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Miro, Jose M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meyer, LaurenceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hasse, BarbaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Konopnicki, DeborahUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roca, BernardinoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barger, DianaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Clifford, Gary M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Franceschi, SilviaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Egger, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bohlius, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-345911
DOI: 10.1002/ijc.32260
Journal or Publication Title: Int. J. Cancer
Volume: 146
Number: 3
Page Range: S. 601 - 610
Date: 2020
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1097-0215
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
INTERNATIONAL EPIDEMIOLOGIC DATABASES; HUMAN-PAPILLOMAVIRUS VACCINATION; EVALUATE AIDS IEDEA; COHORT PROFILE; INFECTED WOMEN; COLLABORATION; IMMUNOSUPPRESSION; COVERAGE; AMERICA; LESIONSMultiple languages
OncologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/34591

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