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Epidemiology & Social: Concise Communication

Low incidence of invasive cervical cancer among HIV-infected US women in a prevention program

Massad, L Stewart; Seaberg, Eric Ca; Watts, D Heatherb; Hessol, Nancy Ac; Melnick, Sandrad; Bitterman, Pincase; Anastos, Kathrynf; Silver, Sylviag; Levine, Alexandra Mh; Minkoff, Howardi

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Objective: To measure the incidence of invasive cervical cancer (ICC) in US women infected with HIV.

Design: Multicenter prospective cohort study, conducted between October 1994, and September 2001.

Setting: HIV research centers operating as six urban consortia in the Women's Interagency HIV Study.

Subjects: A total of 2131 women (462 HIV seronegative, 1661 HIV seropositive, and eight seroconverters). Women with a history of hysterectomy or of cervical cancer at baseline evaluation were excluded.

Intervention: Cervical cytology obtained at 6-month intervals, with a colposcopy referral threshold of atypia, followed by individualized treatment.

Main outcome measure: ICC diagnoses obtained from study databases and regional cancer registries and confirmed by a gynecologic pathologist.

Results: No incident ICC were observed in HIV seronegative women during 2375 woman-years of observation. During 8260 woman-years of observation, eight putative incident cases of cervical cancer were identified in HIV seropositive women, but only one was confirmed, yielding an incidence rate of 1.2/10 000 woman-years (95% confidence interval, 0.3–6.7/10 000 woman-years). The difference in incidence between HIV seropositive and seronegative women was not significant (P = 1.0).

Conclusion: ICC is uncommon in HIV-infected US women participating in a regular prevention program.

© 2004 Lippincott Williams & Wilkins, Inc.


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