Elizabeth A Stier1, Eric Engels2, Marie-Josèphe Horner2, William T Robinson3, Baozhen Qiao4, Jennifer Hayes5, Rana Bayakly6, Bridget J Anderson7, Lou Gonsalves8, Karen S Pawlish9, Diego Zavala10, Analise Monterosso11, Meredith S Shiels2. 1. Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA. 2. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD. 3. STD/HIV/Hepatitis Program, Louisiana Office of Public Health, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA. 4. New York State Cancer Registry, New York State Department of Health, Albany, NY. 5. Maryland Cancer Registry, Maryland Department of Health, Baltimore, MD. 6. Georgia Department of Health, Atlanta, GA. 7. Bureau of Communicable Disease Control, New York State Department of Health, Albany, NY. 8. Connecticut Tumor Registry, Connecticut Department of Public Health, Hartford, CT. 9. Cancer Epidemiology Services, New Jersey Department of Health, Trenton, NJ. 10. Puerto Rico Central Cancer Registry, Comprehensive Cancer Center, University of Puerto Rico, San Juan, PR. 11. HIV/STD/HCV Epidemiology and Surveillance Branch, Department of State Health Services, Austin, TX, USA.
Abstract
OBJECTIVE: Recommendations for the age of initiating screening for cervical cancer in women with HIV (WWH) in the United States have not changed since 1995 when all women (regardless of immune status) were screened for cervical cancer from the age of onset of sexual activity, which often occurs in adolescence. By 2009, recognizing the lack of benefit as well as harms in screening young women, guidelines were revised to initiate cervical cancer screening for the general population at age 21 years. By comparing cervical cancer incidence in young WWH to that of the general population, we assessed the potential for increasing the recommended age of initiating cervical cancer screening in WWH. DESIGN: We compared age-specific invasive cervical cancer (ICC) rates among WWH to the general population in the United States HIV/AIDS Cancer Match Study. METHODS: We estimated standardized incidence ratios as the observed number of cervical cancer cases among WWH divided by the expected number, standardized to the general population by age, race/ethnicity, registry, and calendar year. RESULTS: ICC rates among WWH were elevated across all age groups between ages 25 and 54 years (SIR = 3.80; 95% CI 3.48--4.15) but there were zero cases among ages less than 25 years. CONCLUSION: The absence of ICC among WWH less than 25 years supports initiating cervical cancer screening at age 21 years, rather than adolescence, to prevent cancers in WWH at ages with higher risk of ICC.
OBJECTIVE: Recommendations for the age of initiating screening for cervical cancer in women with HIV (WWH) in the United States have not changed since 1995 when all women (regardless of immune status) were screened for cervical cancer from the age of onset of sexual activity, which often occurs in adolescence. By 2009, recognizing the lack of benefit as well as harms in screening young women, guidelines were revised to initiate cervical cancer screening for the general population at age 21 years. By comparing cervical cancer incidence in young WWH to that of the general population, we assessed the potential for increasing the recommended age of initiating cervical cancer screening in WWH. DESIGN: We compared age-specific invasive cervical cancer (ICC) rates among WWH to the general population in the United States HIV/AIDS Cancer Match Study. METHODS: We estimated standardized incidence ratios as the observed number of cervical cancer cases among WWH divided by the expected number, standardized to the general population by age, race/ethnicity, registry, and calendar year. RESULTS: ICC rates among WWH were elevated across all age groups between ages 25 and 54 years (SIR = 3.80; 95% CI 3.48--4.15) but there were zero cases among ages less than 25 years. CONCLUSION: The absence of ICC among WWH less than 25 years supports initiating cervical cancer screening at age 21 years, rather than adolescence, to prevent cancers in WWH at ages with higher risk of ICC.
Authors: Daniel C Beachler; Joseph E Tota; Michelle I Silver; Aimée R Kreimer; Allan Hildesheim; Nicolas Wentzensen; Mark Schiffman; Meredith S Shiels Journal: Gynecol Oncol Date: 2016-11-26 Impact factor: 5.482
Authors: L Stewart Massad; Nancy A Hessol; Teresa M Darragh; Howard Minkoff; Christine Colie; Rodney L Wright; Mardge Cohen; Eric C Seaberg Journal: Int J Cancer Date: 2017-07-17 Impact factor: 7.396
Authors: Maria Kyrgiou; Antonios Athanasiou; Maria Paraskevaidi; Anita Mitra; Ilkka Kalliala; Pierre Martin-Hirsch; Marc Arbyn; Phillip Bennett; Evangelos Paraskevaidis Journal: BMJ Date: 2016-07-28