1. Assessing national cervical cancer screening guidelines: Results from an HIV testing clinic also screening for cervical cancer and HPV in Soweto, South Africa
- Author
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Tanya Doherty, Janan Dietrich, Khuthadzo Hlongwane, Maya Jaffer, Kathryn L. Hopkins, Kennedy Otwombe, Jacobus Olivier, Glenda Gray, and Mireille Cheyip
- Subjects
0301 basic medicine ,RNA viruses ,Viral Diseases ,Health Screening ,Human immunodeficiency virus (HIV) ,Uterine Cervical Neoplasms ,HIV Infections ,medicine.disease_cause ,Cervical cancer screening ,Cervical Cancer ,Pathology and Laboratory Medicine ,HIV Testing ,South Africa ,0302 clinical medicine ,Medical Conditions ,Immunodeficiency Viruses ,Medicine and Health Sciences ,Public and Occupational Health ,030212 general & internal medicine ,Early Detection of Cancer ,Cervical cancer ,Multidisciplinary ,Obstetrics ,virus diseases ,Infectious Diseases ,Oncology ,Medical Microbiology ,Liquid-based cytology ,Viral Pathogens ,Viruses ,Practice Guidelines as Topic ,Medicine ,Female ,Pathogens ,Cancer Screening ,Research Article ,Papanicolaou Test ,Adult ,medicine.medical_specialty ,Human Papillomavirus Infection ,Papillomaviruses ,Science ,Urology ,Sexually Transmitted Diseases ,Hiv testing ,Microbiology ,HPV-16 ,03 medical and health sciences ,Abnormal PAP Smear ,Diagnostic Medicine ,Statistical significance ,Retroviruses ,medicine ,Cancer Detection and Diagnosis ,Humans ,Human papillomavirus ,Microbial Pathogens ,Vaginal Smears ,Health Care Policy ,business.industry ,Genitourinary Infections ,Lentivirus ,Papillomavirus Infections ,Organisms ,Cancers and Neoplasms ,Biology and Life Sciences ,HIV ,Human Papillomavirus ,medicine.disease ,Health Care ,030104 developmental biology ,business ,DNA viruses ,Gynecological Tumors ,Screening Guidelines - Abstract
Objective A screening centre in Soweto, South Africa (SA), investigated high-risk human papillomavirus (HR-HPV), HIV, cervical cancer risk amongst women. Methods This cross-sectional study (June 2018-March 2019) describes screening results (Roche Linear Array HPV test and Pap smear liquid based cytology) and history of screening (known HIV status, antiretroviral therapy [ART] use, previous Pap smears). Data were stratified by age group (18โ29, 30+ years), HIV status, Pap smear results and tested for statistical significance. Results Of 280 women, 20.4% were HIV-positive, 18.2% had abnormal Pap smears, 41.8% had HR-HPV. Of older women, 48.2% (n = 78/162) had never had a Pap smear. Of younger women, 89.0% (n = 105/118) never had a Pap smear, but had significantly more low-grade squamous intraepithelial lesions (LSIL) and other HR-HPV infection than older women (12.7%[n = 15/118] vs 4.9%[n = 8/162], p = 0.0193; and 49.2%[n = 58/118] vs 29.0%[n = 47/162], p = 0.0006; respectively). HIV-positive women had more abnormal cytology results and infection with other HR-HPV types or co-infection with other HR-HPV type(s)/HPV-16 compared to HIV-negative women (35.1%[n = 20/57] vs 13.9%[n = 31/223], p = 0.0002; 56.1%[n = 32/57] vs 32.7%[n = 73/223], p = 0.001; and 12.3%[n = 7/57] vs 4.9%[n = 11/223], p = 0.044; respectively). Of 57 HIV-positive women, 45.6% (n = 26) already knew their HIV status; of which 69.2% were on ART and 34.6% never had a Pap smear. Conclusion South African women have high rates of HIV, Pap smear abnormalities and HR-HPV, with low cervical cancer screening coverage. SA cervical cancer screening policy excludes (undiagnosed) HIV-positive and HIV-negative women
- Published
- 2021