Cervical Cancer Among Women With HIV in South Carolina During the Era of Effective Antiretroviral Therapy

• Published in: Journal of lower genital tract disease Vol. 26; no. 2; p. 109
• Main Authors: Nissim, Oriel, Dees, Aariel, Cooper, S Lewis, Patel, Khilen, Lazenby, Gweneth B
• Format: Journal Article
• Language: English
• Published: United States 01.04.2022
• Subjects: Adult; Female; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - epidemiology; Humans; Mass Screening; Retrospective Studies; South Carolina - epidemiology; Uterine Cervical Neoplasms - diagnosis; Young Adult; South Carolina
• ISSN: 1526-0976
• DOI: 10.1097/LGT.0000000000000656

We aimed to determine whether women with HIV (WWH) and cervical cancer were more likely to experience cancer-related death and to be diagnosed with cervical cancer at a younger age and in more advanced stages. This is a retrospective cohort study of all women diagnosed with cervical cancer in South Carolina from 1998 to 2018. Deidentified data were obtained from 2 statewide databases. A survival analysis was performed to evaluate differences in cancer survival between women with and without HIV. Wilcoxon rank sum test was used to determine differences in the median age at cancer diagnosis. χ2 test was used to assess differences in cancer stage according to HIV status. Four thousand three hundred fourteen women were diagnosed with cervical cancer, and 53 (1.2%) had HIV infection. Survival time in months was similar between WWH and HIV-negative women (86 months [interquartile range {IQR} = 32-146] and 62 months [IQR = 18-153], p = .37; log-rank p = .26). Compared with HIV-negative women, WWH were less likely to experience cervical cancer-related death (36% vs. 19%, p = .005). Women with HIV were diagnosed with cervical cancer at a younger age (44 [IQR = 37-54] vs. 49 [IQR = 39-61], p = .02). Cervical cancer stage was similar at diagnosis between groups (tumor node metastasis stage, p = .97, and Surveillance, Epidemiology, and End Results summary stage, p = .41). Women with HIV were younger at diagnosis than HIV-negative women, but they were no more likely to die from or have more advanced cervical cancer. Women with HIV were not more likely to develop cervical cancer before the age of 21 years and earlier screening is likely unnecessary.