Age trends in the prevalence of cervical squamous intraepithelial lesions among HIV-positive women in Cameroon: A cross-sectional study

被引：8
作者：
Atashili J. [1 ,2 ]
Miller W.C. [3 ]
Smith J.S. [3 ]
Ndumbe P.M. [1 ,2 ]
Ikomey G.M. [1 ,2 ]
Eron J. [3 ]
Rinas A.C. [3 ]
Myers E. [3 ]
Adimora A.A. [3 ]
机构：
[1] University of Buea, Molyko Buea
[2] University of Yaounde I, Yaounde
[3] University of North Carolina at Chapel Hill, Chapel Hill, NC
来源：
BMC Research Notes | / 5卷 / 1期
关键词：
Cervical Cancer; Human Papilloma Virus; Precancerous Lesion; Prevalence Difference; Atypical Squamous Cell;
D O I：
10.1186/1756-0500-5-590
中图分类号：
学科分类号：
摘要：
Background: Cervical squamous intra-epithelial lesions (SIL) are more frequent in HIV-positive women overall. However the appropriate age at which to begin and end cervical cancer screening for early detection of lesions in HIV-positive women is not clear. We assessed the age-specific prevalence of any SIL and SIL requiring colposcopy in HIV-positive women in Cameroon. Methods. We enrolled, interviewed and conducted conventional cervical cytology in 282 women, aged 19-68 years, initiating antiretroviral therapy in three clinics in Cameroon. In bivariable analyses, the crude relationship between age and the presence of lesions was assessed using locally weighted regression (LOWESS) methods. In multivariate analyses, generalized linear models with prevalence as the outcome, an identity link and a binomial distribution, were used to estimate prevalence differences. Bias analyses were conducted to assess the potential effect of inaccuracies in cytology. Results: SIL were detected in 43.5% of the 276 women with satisfactory samples, 17.8% of whom had ASC-H/HSIL. On average, women aged 26 to 59 tended to have a slightly higher prevalence of any SIL than other women (Prevalence difference PD: 6.5%; 95%CI: -11.4, 24.4%). This PD was a function of CD4 count (heterogeneity test p-value =0.09): amongst patients with CD4 counts less than 200cells/uL, the prevalence was higher in patients aged 26-59, while there was essentially no difference amongst women with CD4 counts greater than 200 cells/uL. ASC-H/HSIL were present in women as young as 19 and as old as 62. Overall the prevalence of ASC-H/HSIL increased by 0.7% (95%CI: -3.8%, 5.1%) per decade increase in age. Conclusion: Both severe and less severe lesions were prevalent at all ages suggesting little utility of age-targeted screening among HIV-positive women. Nevertheless, the long-term evolution of these lesions needs to be assessed in prospective studies. © 2012 Atashili et al.; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 29 条
  • [11] De Vuyst H., Lillo F., Broutet N., Smith J.S., HIV, human papillomavirus, and cervical neoplasia and cancer in the era of highly active antiretroviral therapy, Eur J Cancer Prev., 17, 6, pp. 545-554, (2008)
  • [12] Solomon D., Davey D., Kurman R., Moriarty A., O'Connor D., Prey M., Raab S., Sherman M., Wilbur D., Wright Jr. T., Young N., The 2001 Bethesda System: Terminology for reporting results of cervical cytology, Journal of the American Medical Association, 287, 16, pp. 2114-2119, (2002)
  • [13] Rothman K.J., Greenland S., Lash T.L., Modern Epidemiology, (2008)
  • [14] Macgregor J.E., Teper S., Uterine cervical cytology and young women, Lancet, 1, 8072, pp. 1029-1031, (1978)
  • [15] Chung H.R., Riccio Jr. J.A., Gerstung R.A., Discovery rate of dysplasia and carcinoma of the uterine cervix in an urban medical center serving patients at high risk, International Journal of Gynecology and Obstetrics, 20, 6, pp. 449-454, (1982)
  • [16] Benmoura D., Sperandeo D., Duprez D., DEPISTAGE CERVICAL ET SURVEILLANCE DU COL AVANT VINGT ANS, Journal de Gynecologie Obstetrique et Biologie de la Reproduction, 15, 1, pp. 63-71, (1986)
  • [17] Sadeghi S.B., Sadeghi A., Cosby M., Olincy A., Robboy S.J., Human papillomavirus infection. Frequency and association with cervical neoplasia in a young population, Acta Cytologica, 33, 3, pp. 319-323, (1989)
  • [18] The prevalence of abnormal cervical cytology in a group of New Zealand women using contraception: A preliminary report. The New Zealand Contraception and Health Study Group, N Z Med J, 102, 872, pp. 369-371, (1989)
  • [19] Das D.K., Murthy N.S., Bhatnager P., Juneja A., Sharma S., Pant J.N., Bhatt N.C., Sharma K.C., Luthra U.K., Efficacy of a hospital based cytology screening program, Neoplasma, 39, 6, pp. 381-384, (1992)
  • [20] Gupta S., Sodhani P., Halder K., Chachra K.L., Singh V., Sehgal A., Age trends in pre-cancerous and cancerous lesions of the uterine cervix in a cytology screening programme: What should be the target age group for a major thrust of screening in resource-limited settings?, Cytopathology, 19, 2, pp. 106-110, (2008)
123