S Grabar1,2, M Hleyhel3,4, A Belot5,6,7,8, A-M Bouvier9, P Tattevin10, J Pacanowski11, P Genet12, C Pradier13, D Salmon14, A Simon15, V Pourcher16, J-P Spano17, I Poizot-Martin18,19, D Costagliola1. 1. Sorbonne University, INSERM, IPLESP (Pierre Louis Institute of Public Health), Paris, France. 2. Unit of Biostatistic and Epidemiology, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Centre University Hospitals, Paris Descartes University, Paris, France. 3. CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon. 4. INSPECT-LB, National Public Health Institute, Clinical Epidemiology and Toxicology, Faculty of Public Health, Lebanese University, Fanar, Lebanon. 5. Department of Biostatistics, Hospices Civils de Lyon, Lyon, France. 6. Department of Chronical Diseases and Trauma, Institute de Veille Sanitaire, Saint-Maurice, France. 7. Laboratory of Biometry and Evolutive Biology, Health-Biostatistics team, CNRS, UMR 5558, Villeurbanne, France. 8. Department of Non-Communicable Disease Epidemiology, London, School of Hygiene and Tropical Medicine, Cancer Survival Group, Faculty of Epidemiology and Population Health, London, UK. 9. INSERM UMR 1231, Burgundy Digestive Cancer Registry, FRANCIM, Dijon University Hospital, Dijon, France. 10. Department of Infectious Diseases and Medical Reanimation, Rennes University Hospital, Pontchaillou Hospital, Rennes, France. 11. Department of Infectious Diseases, AP-HP, Saint Antoine University Hospital, Paris, France. 12. Hematology and AIDS Department, Argenteuil Hospital, Argenteuil, France. 13. Department of Public Health, Nice University Hospital, L'Archet Hospital, Nice, France. 14. Unit of Infectious Diseases, Paris Centre University Hospitals, AP-HP, Paris Descartes University, Paris, France. 15. Department of Infectious Diseases, Pitié Salpêtrière University Hospital, AP-HP, Paris, France. 16. INSERM U1136, AP-HP Department of Infectious Diseases, Pitié Salpêtrière - Charles Foix University Hospital, Sorbonne University, Paris, France. 17. Medical Oncology Department, Pitié Salpêtrière University Hospital, AP-HP, IPLESP, Sorbonne University, INSERM, Paris, France. 18. Clinical Immuno-Hematology Department, Aix-Marseille University, Sainte-Marguerite University Hospital, Marseille, France. 19. Inserm U912 (SESSTIM-Health Economic and Social Sciences and Medical Informatics), Marseille, France.
Abstract
OBJECTIVES: We examined trends in the incidence rates of invasive cervical cancer (ICC) and in the rate of survival after ICC among women living with HIV (WLHIV) in France and compared them to those of the general population. METHODS: Histologically validated incident cases of ICC in the period 1992-2009 from the French Hospital Database on HIV (FHDH-ANRS CO4) were included in the study. Age-standardized incidence rates were estimated for FHDH and the general population in France for 1992-1996 [pre-combination antiretroviral therapy (cART) period], 1997-2000 (early cART period), 2001-2004 (intermediate cART period), and 2005-2009 (late cART period). Age-standardized incidence ratios (SIRs) were calculated. Five-year survival was compared with that of the general population for ICC diagnosed in 2005-2009 after standardization for age. RESULTS: Among 28 977 WLHIV, 60 incident ICCs were histologically validated. There was a nonsignificant decreasing trend for the incidence across the cART periods (P = 0.07), from 60 to 36/100 000 person-years. The risk of ICC was consistently significantly higher in WLHIV than in the general population; the SIR was 5.4 [95% confidence interval (CI) 3.0-8.9] during the pre-cART period and 3.3 (95% CI 2.2-4.7) in 2005-2009. Survival after ICC did not improve across periods (log-rank P = 0.14), with overall estimated 5-year survival of 78% (95% CI 0.67-0.89%). Five-year survival was similar for WLHIV and the general population for women diagnosed with ICC in 2005-2009, after standardization (P = 0.45). CONCLUSIONS: ICC risk is still more than three times higher in WLHIV than in the general population. Survival after ICC did not improve over time and was similar to that of the general population during the most recent period. Such results call for promotion of the uptake of screening in WLHIV.
OBJECTIVES: We examined trends in the incidence rates of invasive cervical cancer (ICC) and in the rate of survival after ICC among women living with HIV (WLHIV) in France and compared them to those of the general population. METHODS: Histologically validated incident cases of ICC in the period 1992-2009 from the French Hospital Database on HIV (FHDH-ANRS CO4) were included in the study. Age-standardized incidence rates were estimated for FHDH and the general population in France for 1992-1996 [pre-combination antiretroviral therapy (cART) period], 1997-2000 (early cART period), 2001-2004 (intermediate cART period), and 2005-2009 (late cART period). Age-standardized incidence ratios (SIRs) were calculated. Five-year survival was compared with that of the general population for ICC diagnosed in 2005-2009 after standardization for age. RESULTS: Among 28 977 WLHIV, 60 incident ICCs were histologically validated. There was a nonsignificant decreasing trend for the incidence across the cART periods (P = 0.07), from 60 to 36/100 000 person-years. The risk of ICC was consistently significantly higher in WLHIV than in the general population; the SIR was 5.4 [95% confidence interval (CI) 3.0-8.9] during the pre-cART period and 3.3 (95% CI 2.2-4.7) in 2005-2009. Survival after ICC did not improve across periods (log-rank P = 0.14), with overall estimated 5-year survival of 78% (95% CI 0.67-0.89%). Five-year survival was similar for WLHIV and the general population for women diagnosed with ICC in 2005-2009, after standardization (P = 0.45). CONCLUSIONS: ICC risk is still more than three times higher in WLHIV than in the general population. Survival after ICC did not improve over time and was similar to that of the general population during the most recent period. Such results call for promotion of the uptake of screening in WLHIV.
Authors: Yannick Q Turdo; Yann Ruffieux; Tebatso M G Boshomane; Hannes Mouton; Katayoun Taghavi; Andreas D Haas; Matthias Egger; Gary Maartens; Eliane Rohner Journal: Gynecol Oncol Rep Date: 2022-09-21