Is HIV infection a risk factor for advanced cervical cancer?
OBJECTIVE
To compare HIV-infected and HIV-negative women with invasive cervical cancer with respect to predictors of advanced disease.


METHODS
A retrospective analysis of 28 HIV-positive and 132 HIV-negative women with invasive cervical carcinoma was conducted and the two groups were compared with regard to stage of disease, demographic and behavioral variables, and risk factors for advanced disease.


RESULTS
Overall, HIV-infected women were more likely to have advanced disease, because 78% of HIV-positive women had Stage II to IV compared with 55% of HIV-negative women (odds ratio [OR] = 3.1; p = .03). Substance abuse was strongly associated with HIV infection, as were high-risk sexual variables. Although HIV infection was associated with a threefold increase in advance stage cervical cancer in a univariate analysis, only symptom duration and lack of a recent Papanicolaou smear were significant predictors of advanced disease in a multiple logistic regression analysis.


CONCLUSIONS
The major predictors of advanced cervical cancer are similar in HIV-positive and HIV-negative women, although the reasons for these predictors may be very different. It is likely that a large proportion of HIV-positive patients with cervical cancer acquire HIV infection after initiation of the neoplastic process.
Department of Obstetrics and Gynecology, State University of New York--Health Science Center at Brooklyn, 11203, USA.
R G
RG
Fruchter
M
M
Maiman
C D
CD
Arrastia
R
R
Matthews
E J
EJ
Gates
K
K
Holcomb
D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D065006:Papanicolaou Test; D012189:Retrospective Studies; D012307:Risk Factors; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000150:complications; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D014626:Vaginal Smears / Q000706:statistics & numerical data