Reduction in prevalence of invasive cervical cancer in KwaZulu-Natal, South Africa: impact of the human immunodeficiency virus epidemic.

The bulk of the human immunodeficiency virus (HIV) pandemic continues to ravage the developing world, especially sub-Saharan countries. The HIV seroprevalence among women with invasive cervical cancer varies in different parts of the world. A comparison of women with cervical cancer was undertaken for epidemiologic data in the province of KwaZulu-Natal, South Africa, which has the highest HIV prevalence. The two time periods of study were 1999 and 2003. The aim was to determine the trends of prevalence of invasive cervical cancer and HIV infection among such women. While the background prevalence of HIV infection among women with invasive cervical cancer in our setting has remained constant over the two time periods (21% and 21.8%), there has been a significant reduction in the number of women presenting with invasive cervical cancer to our center (672 to 271) over the two time periods, with no changes in other variables. On the contrary, the prevalence of HIV infection among antenatal attendees had risen from 32.5% to 38.5% in the 1999 and 2003 periods, respectively. Reasons for this dramatic trend are presented together with other epidemiologic data.