Back to Search
Start Over
The association between HIV infection and cervical cancer presentation and survival in Uganda
- Source :
- Gynecologic Oncology Reports, Gynecologic Oncology Reports, Vol 31, Iss, Pp-(2020)
- Publication Year :
- 2019
-
Abstract
- Highlights • This is one of the first studies on cervical cancer survival in a low-income country. • In Uganda, cervical cancer is often incompletely treated and survival remains poor. • HIV infection in this cohort was not associated with stage at diagnosis. • HIV was weakly associated with shorter survival.<br />Our objective was to determine how HIV infection impacts cervical cancer stage at presentation and overall survival (OS) among Ugandan women. This was a prospective study of 149 women diagnosed with cervical cancer from 2013 to 2015 at the Uganda Cancer Institute. Poisson regression models were fit to calculate prevalence ratios (PR) for the association between HIV infection and late stage at cancer diagnosis. The association between HIV infection and OS after cervical cancer diagnosis was evaluated using Cox proportional hazards models. The cohort included 53 HIV-positive and 96 HIV-negative participants. Median age at diagnosis was 44 years for HIV-positive and 54 years for HIV-negative participants. Seventy-seven percent of HIV-positive participants received antiretroviral therapy. Median baseline CD4 count was 373 cells/mm3 for HIV-positive participants versus 926 cells/mm3 for HIV-negative participants. Thirty-two percent of HIV-positive participants were diagnosed with late stage cervical cancer (III-IV) versus 39% of HIV-negative participants. No association was found between late stage at cancer diagnosis and HIV infection (PR adjusted for age, parity and transport cost 1.0, 95%CI 0.6–1.8). Most women presenting for care received cancer treatment, though almost half who received radiotherapy did not complete treatment. The median OS was 13.7 months for HIV-positive participants and 24.3 months for HIV-negative participants. After adjusting for age and stage, HIV infection was weakly associated with OS (HR 1.3, 95%CI 0.8–2.2). In Uganda, cervical cancer is often incompletely treated and survival remains poor. HIV infection was not associated with cervical cancer stage at diagnosis, but may be weakly associated with shorter survival.
- Subjects :
- medicine.medical_specialty
Survival
medicine.medical_treatment
Global health
lcsh:Gynecology and obstetrics
lcsh:RC254-282
03 medical and health sciences
symbols.namesake
0302 clinical medicine
Acquired immunodeficiency syndrome (AIDS)
Internal medicine
medicine
Uganda
Poisson regression
Prospective cohort study
lcsh:RG1-991
Cervical cancer
030219 obstetrics & reproductive medicine
Sub-Saharan Africa
Proportional hazards model
business.industry
Obstetrics and Gynecology
Cancer
virus diseases
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
3. Good health
Radiation therapy
Oncology
030220 oncology & carcinogenesis
Cohort
symbols
HIV/AIDS
Narrative Review
business
Subjects
Details
- ISSN :
- 23525789
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Gynecologic oncology reports
- Accession number :
- edsair.doi.dedup.....7b2efe3bb9713cfcee736729d40de9cc