Epidemiology of Cervical Adenocarcinoma and Squamous Cell Carcinoma Among Women Living With Human Immunodeficiency Virus Compared With the General Population in the United States
Open Access
- 18 June 2021
- journal article
- research article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 74 (5), 814-820
- https://doi.org/10.1093/cid/ciab561
Abstract
Although cervical cancer risk overall is elevated among women living with human immunodeficiency virus (HIV; WLH), it is unclear whether risks are similarly elevated across histologic subtypes. Data from the HIV/AIDS Cancer Match Study, a linkage of 12 US HIV and cancer registries during 1996 -2016, were used. Cervical cancers were categorized as adenocarcinoma (AC), squamous cell carcinoma (SCC), or other histologic subtype. Standardized incidence ratios compared rates of AC and SCC in WLH to those in general population. For WLH, risk factors for AC and SCC were evaluated using Poisson regression. Five-year survival was estimated by HIV status and histology. Overall, 62 615 cervical cancers were identified, including 609 in WLH. Compared with the general population, incidence of AC was 1.47 times higher (95% confidence interval [CI]: 1.03–2.05) and SCC was 3.62 times higher among WLH (95% CI: 3.31–3.94). Among WLH, there was no difference in AC rates by race/ethnicity or HIV transmission group, although SCC rates were lower among White women (vs Black) and higher among women who inject drugs (vs heterosexual transmission). Among WLH, 5-year overall survival was similar for AC (46.2%) and SCC (43.8%) but notably lower than for women not living with HIV. Among WLH, AC rates were modestly elevated, whereas SCC rates were greatly elevated compared with the general population. These findings suggest there may be differences in the impact of immunosuppression and HIV in the development of AC versus SCC, given their common etiology in human papillomavirus infection.Keywords
Funding Information
- National Cancer Institute
- Center for Disease Control
- National Program of Cancer Registries (NU58DP006347-01, 5U58DP003875-01, NU58DP006332-03-00, NU58DP006333, 17NU58DP006334, NU58/DP003931-05-00, 6NU58/DP006309, 1NU58DP006281, 1NU58DP006308)
- CDC Cooperative Agreement (DP006302)
- Surveillance, Epidemiology, and End Results
- National Cancer Institute (HHSN261201800002I, HHSN261201800007I/ HHSN26100002, HHSN261201800009I, HHSN261201300021I, N01-PC-2013-00021)
- State of New Jersey
- State of Maryland
- Maryland Cigarette Restitution Fund
- State of Louisiana (0587200015)
- State of New York
- CDC National HIV Surveillance Systems (NU62PS003960, 5U62PS001005-05, NU62PS924522-02-00, U62PS004011-02, U62PS004001-2, NU62PS924546-02-00, PS18-1802)
- Integrated HIV Surveillance and Prevention Programs for Health Departments
- National Center for HIV, Viral Hepatitis, STD, and TB Prevention
- National Institutes of Health
- NCI-funded Johns Hopkins Specialized Programs of Research Excellence in Cervical Cancer (P50CA098252-16)
This publication has 29 references indexed in Scilit:
- Incidence and progression of cervical lesions in women with HIV: a systematic global reviewInternational Journal of STD & AIDS, 2013
- Human papillomavirus (HPV) genotypes and HPV16 variants and risk of adenocarcinoma and squamous cell carcinoma of the cervixGynecologic Oncology, 2011
- Prospective study of human papillomavirus and risk of cervical adenocarcinomaInternational Journal of Cancer, 2010
- CD4+ T cells against human papillomavirus‐18 E7 in patients with high‐grade cervical lesions associate with the absence of the virus in the cervixImmunology, 2010
- Histologic Correlates of Glandular Abnormalities in Cervical Cytology Among Women With Human Immunodeficiency VirusObstetrics & Gynecology, 2009
- Human Papillomavirus Infection and Cervical Disease in Human Immunodeficiency Virus-1–Infected WomenObstetrics & Gynecology, 2008
- Prevalence and risk factors of squamous intraepithelial lesions of the cervix among HIV-infected women – a long-term follow-up study in a low-prevalence populationInternational Journal of STD & AIDS, 2006
- Human papillomavirus types among women infected with HIV: a meta-analysisAIDS, 2006
- Cervical squamous intraepithelial lesions in HIV-infected women: prevalence, incidence and regressionAIDS, 2000
- Are adenocarcinomas and adenosquamous carcinomas different from squamous carcinomas in stage IB and II cervical cancer patients undergoing primary radical surgery?International Journal of Gynecologic Cancer, 1999