Cancer treatment and survival among cervical cancer patients living with or without HIV in South Africa.

Autor:	Turdo YQ; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland., Ruffieux Y; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland., Boshomane TMG; Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa., Mouton H; Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa., Taghavi K; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland., Haas AD; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland., Egger M; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa., Maartens G; Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa., Rohner E; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Jazyk:	angličtina
Zdroj:	Gynecologic oncology reports [Gynecol Oncol Rep] 2022 Sep 21; Vol. 43, pp. 101069. Date of Electronic Publication: 2022 Sep 21 (Print Publication: 2022).
DOI:	10.1016/j.gore.2022.101069
Abstrakt:	Objective: To compare cancer treatment and all-cause mortality between HIV-positive and HIV-negative cervical cancer patients in South Africa. Methods: We assessed cancer treatment and all-cause mortality in HIV-positive and HIV-negative cervical cancer patients who received cancer treatment within 180 days of diagnosis using reimbursement claims data from a private medical insurance scheme in South Africa between 01/2011 and 07/2020. We assessed treatment provision using logistic regression and factors associated with all-cause mortality using Cox regression. We assigned missing values for histology and ethnicity using multiple imputation. Results: Of 483 included women, 136 (28 %) were HIV-positive at cancer diagnosis (median age: 45.7 years), and 347 (72 %) were HIV-negative (median age: 54.1 years). Among 285 patients with available ICD-O-3 morphology claims codes, the proportion with cervical adenocarcinoma was substantially lower in HIV-positive (4 %) than in HIV-negative patients (26 %). Most HIV-positive patients (67 %) were on antiretroviral therapy at cancer diagnosis. HIV-positive patients were more likely to receive radiotherapy (adjusted odds ratio [aOR] 1.90, 95 % confidence interval [CI] 1.05-3.45) or chemotherapy (aOR 2.02, 95 %CI 0.92-4.43) and less likely to undergo surgery (aOR 0.53, 95 %CI 0.31-0.90) than HIV-negative patients. HIV-positive patients were at a higher risk of death from all causes than HIV-negative patients (adjusted hazard ratio 1.52, 95 %CI 1.06-2.19). Other factors associated with higher all-cause mortality included age > 60 years and metastases at diagnosis. Conclusions: HIV-positive cervical cancer patients in South Africa had higher all-cause mortality than HIV-negative patients which could be explained by differences in tumour progression, clinical care, and HIV-specific mortality. Competing Interests: TMGB is on the advisory boards of Discovery Health Medical Scheme and serves as a senior medical advisor on HIV within Aid for AIDS/Medscheme. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2022 The Authors.)
Databáze:	MEDLINE
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