Invasive cervical cancer and human immunodeficiency virus (HIV) infection at Tygerberg Academic Hospital in the period 2003–2007: demographics and characteristics

Abstract

AFRICAN DEVELOPMENT Abstract: Background: Despite the prevalence of HIV infection in women with pre-invasive and invasive cervical diseases managed at the Gynaecologic Oncology unit of Tygerberg Hospital, there is a lack of local data on the effect HIV/AIDS has on invasive cervical cancer cases managed at this large tertiary institution. Cervical cancer is the most common gynaecological malignancy at Tygerberg Hospital.Objectives: To establish the following in the local cervical cancer population: (1) HIV prevalence; (2) demographics and clinical characteristics (i.e. stage, histology) in HIV seronegative and seropositive women.Methods: A retrospective, descriptive study. Study population: all cases of HIV/AIDS-affected women diagnosed with invasive cervical cancer and managed at the combined gynaecological oncology clinic in Tygerberg Hospital (TBH) compared with HIV/ AIDS-unaffected women with cervical cancer 2003–2007; with a follow-up period ending 31 December 2009.Results: In the period 2003–2007, 913 cases of invasive cervical cancer were seen at Tygerberg Academic Hospital (TBH). A total of 838 subjects were HIV seronegative and 75 were HIV seropositive. HIV seropositive subjects were 10 years younger compared with those who were HIV seronegative. The majority of patients in both cohorts never had cervical cytology documented prior to invasive cancer diagnosis. Most women presented with FIGO stages III–IV disease.Conclusion: HIV-affected women present 10 years younger with cervical cancer compared with their HIV-unaffected counterparts. Effective screening is still lacking in this population. The majority of women present with advanced cervical cancer