Association between invasive cancer of the cervix and HIV-1 infection in Tanzania: the need for dual screening
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Date
2008
Journal Title
Journal ISSN
Volume Title
Publisher
BMC public health
Abstract
Cancer of the cervix is the second commonest malignancy in females worldwide and
is the leading malignancy among women in Tanzania. Cancer of the cervix has been strongly
associated with Human Papilloma Virus (HPV) which is a sexually transmitted disease. However,
the role of HIV-1 in the aetiology of cancer of the cervix is less clear. Studies suggest that HPV and
HIV-1 infection are synergistic and therefore their dual occurrence may fuel increased incidence of
cancer of the cervix and AIDS. We therefore conducted a study to determine the association
between cancer of the cervix and HIV-1.
Methods: The study was carried out in Ocean Road Cancer Institute, Dar-es-salaam, Tanzania
between January and March 2007. A hospital-based case control design was used to study 138 cases
and 138 controls. The cases were consenting women 18 years and above with histologically
confirmed squamous cell carcinoma of the cervix, while the controls were consenting non-cancer
adult women attendants or visitors. The participants were counselled and tested for HIV-1 and
interviewed to assess risk factors for cancer of the cervix and HIV-1. Estimation of risk was done
by computing odds ratios and confidence intervals. Confounding and interaction between the
factors were assessed using logistic regression.
Results: HIV-1 prevalence was much higher among the cases (21.0%) than among the controls
(11.6%). In logistic regression, HIV-1 was associated with cancer of the cervix (OR = 2.9, 95% CI
= 1.4–5.9). Among the casesthe mean age was lower for HIV-1 infected (44.3 years) than HIV-1
uninfected women (54 years, p = 0.0001).
Conclusion: HIV-1 infection is associated with invasive cancer of the cervix. Resourceconstrained
countries with a high burden of HIV-1 and cervical cancer should adopt a high-risk
approach that targets HIV-1 positive women for screening of cervical cancer initially by utilizing
HIV/AIDS resources.
Description
Keywords
Cancer of the cervix, HIV-1 infection, Tanzania, Dual screening
Citation
Kahesa, C., Mwaiselage, J., Wabinga, H. R., Ngoma, T., Kalyango, J. N., & Karamagi, C. A. (2008). Association between invasive cancer of the cervix and HIV-1 infection in Tanzania: the need for dual screening. BMC public health, 8(1), 1-8. doi:10.1186/1471-2458-8-262