Incidence of cervical dysplasia and cervical cancer in women living with HIV in Denmark: comparison with the general population

Kristina Thorsteinsson, Steen Ladelund, Søren Jensen-Fangel, Terese Lea Katzenstein, Isik Somuncu Johansen, Gitte Pedersen, Jette Junge, Marie Helleberg, Merete Storgaard, Niels Obel, Anne-Mette Lebech

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

INTRODUCTION: Women living with HIV (WLWH) are reportedly at increased risk of invasive cervical cancer (ICC). WLWH in Denmark attend the National ICC screening program less often than women in the general population. We aimed to estimate the incidence of cervical dysplasia and ICC in WLWH in Denmark.

METHODS: We studied a nationwide cohort of WLWH and a cohort of age-matched females from the general population in the period 1999-2010. Pathology samples were obtained from The Danish Pathology Data Bank containing nationwide records of all pathology specimens. The cumulative incidence and hazard ratios (HRs) for time from inclusion to first cervical intraepithelial neoplasia (CIN)/ICC and time from first normal cervical cytology to first CIN/ICC were estimated. Sensitivity analyses were performed to include prior screening outcome, screening intensity and treatment of CIN/ICC in the interpretation of results.

RESULTS: We followed 1,143 WLWH and 17,145 controls with no prior history of ICC for 9,509 and 157,362 person-years. Compared to controls, the overall incidence of CIN1 or worse (CIN1+), CIN2+ and CIN3+ was higher in WLWH and predicted by young age and CD4 count <200 cells/µL. In women with normal baseline cytology, incidences of CIN1+ and CIN2+ were higher in WLWH. However, incidences were comparable between WLWH and controls adherent to the National ICC screening program.

CONCLUSIONS: Overall, WLWH develop more cervical disease than controls. However, incidences of CIN are comparable amongst WLWH and controls adherent to the National ICC screening program and with a normal baseline cytology.

OriginalsprogEngelsk
TidsskriftInternational AIDS Society. Journal
Vol/bind17
Udgave nummer4 Suppl 3
Sider (fra-til)19646
ISSN1758-2652
DOI
StatusUdgivet - 2014

Fingeraftryk

Uterine Cervical Dysplasia
Denmark
Uterine Cervical Neoplasms
HIV
Incidence
Population
Cervical Intraepithelial Neoplasia
Early Detection of Cancer
Cell Biology
Pathology

Citer dette

Thorsteinsson, Kristina ; Ladelund, Steen ; Jensen-Fangel, Søren ; Katzenstein, Terese Lea ; Johansen, Isik Somuncu ; Pedersen, Gitte ; Junge, Jette ; Helleberg, Marie ; Storgaard, Merete ; Obel, Niels ; Lebech, Anne-Mette. / Incidence of cervical dysplasia and cervical cancer in women living with HIV in Denmark : comparison with the general population. I: International AIDS Society. Journal. 2014 ; Bind 17, Nr. 4 Suppl 3. s. 19646.
@article{89695a5b68be4c989e1cd0fc111d0e34,
title = "Incidence of cervical dysplasia and cervical cancer in women living with HIV in Denmark: comparison with the general population",
abstract = "INTRODUCTION: Women living with HIV (WLWH) are reportedly at increased risk of invasive cervical cancer (ICC). WLWH in Denmark attend the National ICC screening program less often than women in the general population. We aimed to estimate the incidence of cervical dysplasia and ICC in WLWH in Denmark.METHODS: We studied a nationwide cohort of WLWH and a cohort of age-matched females from the general population in the period 1999-2010. Pathology samples were obtained from The Danish Pathology Data Bank containing nationwide records of all pathology specimens. The cumulative incidence and hazard ratios (HRs) for time from inclusion to first cervical intraepithelial neoplasia (CIN)/ICC and time from first normal cervical cytology to first CIN/ICC were estimated. Sensitivity analyses were performed to include prior screening outcome, screening intensity and treatment of CIN/ICC in the interpretation of results.RESULTS: We followed 1,143 WLWH and 17,145 controls with no prior history of ICC for 9,509 and 157,362 person-years. Compared to controls, the overall incidence of CIN1 or worse (CIN1+), CIN2+ and CIN3+ was higher in WLWH and predicted by young age and CD4 count <200 cells/µL. In women with normal baseline cytology, incidences of CIN1+ and CIN2+ were higher in WLWH. However, incidences were comparable between WLWH and controls adherent to the National ICC screening program.CONCLUSIONS: Overall, WLWH develop more cervical disease than controls. However, incidences of CIN are comparable amongst WLWH and controls adherent to the National ICC screening program and with a normal baseline cytology.",
author = "Kristina Thorsteinsson and Steen Ladelund and S{\o}ren Jensen-Fangel and Katzenstein, {Terese Lea} and Johansen, {Isik Somuncu} and Gitte Pedersen and Jette Junge and Marie Helleberg and Merete Storgaard and Niels Obel and Anne-Mette Lebech",
year = "2014",
doi = "10.7448/IAS.17.4.19646",
language = "English",
volume = "17",
pages = "19646",
journal = "International AIDS Society. Journal",
issn = "1758-2652",
publisher = "BioMed Central",
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Thorsteinsson, K, Ladelund, S, Jensen-Fangel, S, Katzenstein, TL, Johansen, IS, Pedersen, G, Junge, J, Helleberg, M, Storgaard, M, Obel, N & Lebech, A-M 2014, 'Incidence of cervical dysplasia and cervical cancer in women living with HIV in Denmark: comparison with the general population', International AIDS Society. Journal, bind 17, nr. 4 Suppl 3, s. 19646. https://doi.org/10.7448/IAS.17.4.19646

Incidence of cervical dysplasia and cervical cancer in women living with HIV in Denmark : comparison with the general population. / Thorsteinsson, Kristina; Ladelund, Steen; Jensen-Fangel, Søren; Katzenstein, Terese Lea; Johansen, Isik Somuncu; Pedersen, Gitte; Junge, Jette; Helleberg, Marie; Storgaard, Merete; Obel, Niels; Lebech, Anne-Mette.

I: International AIDS Society. Journal, Bind 17, Nr. 4 Suppl 3, 2014, s. 19646.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Incidence of cervical dysplasia and cervical cancer in women living with HIV in Denmark

T2 - comparison with the general population

AU - Thorsteinsson, Kristina

AU - Ladelund, Steen

AU - Jensen-Fangel, Søren

AU - Katzenstein, Terese Lea

AU - Johansen, Isik Somuncu

AU - Pedersen, Gitte

AU - Junge, Jette

AU - Helleberg, Marie

AU - Storgaard, Merete

AU - Obel, Niels

AU - Lebech, Anne-Mette

PY - 2014

Y1 - 2014

N2 - INTRODUCTION: Women living with HIV (WLWH) are reportedly at increased risk of invasive cervical cancer (ICC). WLWH in Denmark attend the National ICC screening program less often than women in the general population. We aimed to estimate the incidence of cervical dysplasia and ICC in WLWH in Denmark.METHODS: We studied a nationwide cohort of WLWH and a cohort of age-matched females from the general population in the period 1999-2010. Pathology samples were obtained from The Danish Pathology Data Bank containing nationwide records of all pathology specimens. The cumulative incidence and hazard ratios (HRs) for time from inclusion to first cervical intraepithelial neoplasia (CIN)/ICC and time from first normal cervical cytology to first CIN/ICC were estimated. Sensitivity analyses were performed to include prior screening outcome, screening intensity and treatment of CIN/ICC in the interpretation of results.RESULTS: We followed 1,143 WLWH and 17,145 controls with no prior history of ICC for 9,509 and 157,362 person-years. Compared to controls, the overall incidence of CIN1 or worse (CIN1+), CIN2+ and CIN3+ was higher in WLWH and predicted by young age and CD4 count <200 cells/µL. In women with normal baseline cytology, incidences of CIN1+ and CIN2+ were higher in WLWH. However, incidences were comparable between WLWH and controls adherent to the National ICC screening program.CONCLUSIONS: Overall, WLWH develop more cervical disease than controls. However, incidences of CIN are comparable amongst WLWH and controls adherent to the National ICC screening program and with a normal baseline cytology.

AB - INTRODUCTION: Women living with HIV (WLWH) are reportedly at increased risk of invasive cervical cancer (ICC). WLWH in Denmark attend the National ICC screening program less often than women in the general population. We aimed to estimate the incidence of cervical dysplasia and ICC in WLWH in Denmark.METHODS: We studied a nationwide cohort of WLWH and a cohort of age-matched females from the general population in the period 1999-2010. Pathology samples were obtained from The Danish Pathology Data Bank containing nationwide records of all pathology specimens. The cumulative incidence and hazard ratios (HRs) for time from inclusion to first cervical intraepithelial neoplasia (CIN)/ICC and time from first normal cervical cytology to first CIN/ICC were estimated. Sensitivity analyses were performed to include prior screening outcome, screening intensity and treatment of CIN/ICC in the interpretation of results.RESULTS: We followed 1,143 WLWH and 17,145 controls with no prior history of ICC for 9,509 and 157,362 person-years. Compared to controls, the overall incidence of CIN1 or worse (CIN1+), CIN2+ and CIN3+ was higher in WLWH and predicted by young age and CD4 count <200 cells/µL. In women with normal baseline cytology, incidences of CIN1+ and CIN2+ were higher in WLWH. However, incidences were comparable between WLWH and controls adherent to the National ICC screening program.CONCLUSIONS: Overall, WLWH develop more cervical disease than controls. However, incidences of CIN are comparable amongst WLWH and controls adherent to the National ICC screening program and with a normal baseline cytology.

U2 - 10.7448/IAS.17.4.19646

DO - 10.7448/IAS.17.4.19646

M3 - Journal article

C2 - 25394150

VL - 17

SP - 19646

JO - International AIDS Society. Journal

JF - International AIDS Society. Journal

SN - 1758-2652

IS - 4 Suppl 3

ER -