Cervical Abnormalities in South African Women Living With HIV With High Screening and Referral Rates.

Autor:	Katz IT; and , Brigham and Women's Hospital; , , and , Harvard Medical School; , Massachusetts General Hospital Center for Global Health; , Boston Children's Hospital; , Dana-Farber Cancer Institute; , Boston University, Boston, MA; , University of KwaZulu-Natal, Durban; , Western Cape Province Department of Health, Cape Town; , R.K. Khan Hospital, Chatsworth, South Africa; and , Canadian Red Cross, Ontario, Canada., Butler LM; and , Brigham and Women's Hospital; , , and , Harvard Medical School; , Massachusetts General Hospital Center for Global Health; , Boston Children's Hospital; , Dana-Farber Cancer Institute; , Boston University, Boston, MA; , University of KwaZulu-Natal, Durban; , Western Cape Province Department of Health, Cape Town; , R.K. Khan Hospital, Chatsworth, South Africa; and , Canadian Red Cross, Ontario, Canada., Crankshaw TL; and , Brigham and Women's Hospital; , , and , Harvard Medical School; , Massachusetts General Hospital Center for Global Health; , Boston Children's Hospital; , Dana-Farber Cancer Institute; , Boston University, Boston, MA; , University of KwaZulu-Natal, Durban; , Western Cape Province Department of Health, Cape Town; , R.K. Khan Hospital, Chatsworth, South Africa; and , Canadian Red Cross, Ontario, Canada., Wright AA; and , Brigham and Women's Hospital; , , and , Harvard Medical School; , Massachusetts General Hospital Center for Global Health; , Boston Children's Hospital; , Dana-Farber Cancer Institute; , Boston University, Boston, MA; , University of KwaZulu-Natal, Durban; , Western Cape Province Department of Health, Cape Town; , R.K. Khan Hospital, Chatsworth, South Africa; and , Canadian Red Cross, Ontario, Canada., Bramhill K; and , Brigham and Women's Hospital; , , and , Harvard Medical School; , Massachusetts General Hospital Center for Global Health; , Boston Children's Hospital; , Dana-Farber Cancer Institute; , Boston University, Boston, MA; , University of KwaZulu-Natal, Durban; , Western Cape Province Department of Health, Cape Town; , R.K. Khan Hospital, Chatsworth, South Africa; and , Canadian Red Cross, Ontario, Canada., Leone DA; and , Brigham and Women's Hospital; , , and , Harvard Medical School; , Massachusetts General Hospital Center for Global Health; , Boston Children's Hospital; , Dana-Farber Cancer Institute; , Boston University, Boston, MA; , University of KwaZulu-Natal, Durban; , Western Cape Province Department of Health, Cape Town; , R.K. Khan Hospital, Chatsworth, South Africa; and , Canadian Red Cross, Ontario, Canada., Giddy J; and , Brigham and Women's Hospital; , , and , Harvard Medical School; , Massachusetts General Hospital Center for Global Health; , Boston Children's Hospital; , Dana-Farber Cancer Institute; , Boston University, Boston, MA; , University of KwaZulu-Natal, Durban; , Western Cape Province Department of Health, Cape Town; , R.K. Khan Hospital, Chatsworth, South Africa; and , Canadian Red Cross, Ontario, Canada., Mould S; and , Brigham and Women's Hospital; , , and , Harvard Medical School; , Massachusetts General Hospital Center for Global Health; , Boston Children's Hospital; , Dana-Farber Cancer Institute; , Boston University, Boston, MA; , University of KwaZulu-Natal, Durban; , Western Cape Province Department of Health, Cape Town; , R.K. Khan Hospital, Chatsworth, South Africa; and , Canadian Red Cross, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Journal of global oncology [J Glob Oncol] 2016 May 04; Vol. 2 (6), pp. 375-380. Date of Electronic Publication: 2016 May 04 (Print Publication: 2016).
DOI:	10.1200/JGO.2015.002469
Abstrakt:	Purpose: To determine the prevalence of screening, cervical dysplasia, and malignancy on the basis of histologic diagnoses from colposcopy and large loop excision of the transformation zone among women living with HIV (WLWH) who attended an urban antiretroviral treatment (ART) clinic in KwaZulu-Natal, South Africa. Materials and Methods: We performed a retrospective cohort study to examine a random sample of 462 WLWH during a 5-year period from 2004 to 2009. Women on ART for < 3 months were excluded. Data were abstracted from electronic records and paper charts to assess rates of cervical abnormalities detected on Pap smears as well as time to colposcopy. Results: During the study period, 432 women (93.5%) had at least one evaluable Papanicolau test. At baseline, 237 women (54.9%) had an abnormal Papanicolau test, and of these patients, 181 (76.3%) had a Papanicolau test that qualified for further colposcopic evaluation. In addition, 115 women (63.5%) received colposcopy within a median of 39 days from referral. This yielded 74 evaluable histologic samples (64.3%), of which 21.6%, 27.0%, 27.0%, and 1.4% had cervical intraepithelial neoplasia (CIN) 1, CIN2, CIN3, and invasive cervical cancer, respectively. Conclusion: In a large sample of WLWH who received ART in KwaZulu-Natal, South Africa, where Papanicolau test coverage and rates of referral for colposcopy and large loop excision of the transformation zone were high, > 75% of women with evaluable histologic samples had evidence of cervical dysplasia or malignancy. These findings underscore the importance of routine cervical screening upon entry into HIV care to optimize survival. Competing Interests: Authors’ disclosures of potential conflicts of interest and contributions are found at the end of this article.The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc. Ingrid T. KatzNo relationship to discloseLisa M. ButlerNo relationship to discloseTamaryn L. CrankshawNo relationship to discloseAlexi A. WrightNo relationship to discloseKaren BramhillNo relationship to discloseDominick A. LeoneNo relationship to discloseJanet GiddyNo relationship to discloseSean MouldNo relationship to disclose
Databáze:	MEDLINE
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