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Download Cervical Cancer: Experiences from a Cohort of HIV Infected Women
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Cervical Cancer: Experiences from a Cohort of HIV-infected Women Pascoe M, Magure T, Mudhokwani P et al Abstract: MOAB0202 Presentation Outline • Background • Objectives • Methodology • Results • Conclusion and recommendations Background • Cervical carcinoma the most common malignancy in Zimbabwean women, is preventable • Women living with HIV (WLWHIV) have higher prevalence of Human Papillomavirus (HPV) infection, & multiple subtypes including oncogenic HPV • They are at risk of higher grade lesions, higher rates of recurrent & persistent cervical disease & invasive cervical cancer (ICC) • Primary prevention with HPV vaccination is possible • Secondary prevention includes screening & treatment of early lesions Objectives This study was done in order to: • Describe the prevalence of cervical disease in a cohort of women receiving care for HIV infection • Provide evidence to support the need for cervical cancer screening for WLWHIV in Zimbabwe Methodology • Newlands Clinic provides comprehensive care & treatment for 5500 patients (60% female) • Cervical cancer screening using visual inspection with acetic acid (VIA) method introduced for sexually active females • VIA & appropriate treatment with either cryotherapy or loop electrosurgical excision procedure (LEEP) • A record review of women undergoing initial cervical screening from Jan 2011 to Dec 2014 • Assessment of women with VIA+ve lesions at initial screening (IS) & histological analysis of 326 biopsies was done Results Percentage of Women with VIA Positive Lesions at IS Year 34.9% (314/899) 2011 32.4% (439/1357) 2012 31.0% (126/406) 2013 33.0% (110/333) 2014 The mean was 32.8 % Histological Diagnosis Histological diagnosis of 326 biopsy specimens obtained during LEEP • CIN I - 15.7% • CIN II - 30.0% • CIN III - 29.4% • ICC - 2% Conclusions & Recommendations • Cervical disease (defined by VIA+ve) was present in 1/3 of women at initial screening • Histology of 326 biopsy specimens showed moderate to severe dysplasia (CIN II & III) in 59.4% & ICC in 2% • These data illustrate the high prevalence of cervical disease & support the need for cervical cancer screening as a mandatory component of care for all WLWHIV • The urgency for HPV vaccination as primary prevention strategy is highlighted Thank you for your attention
