Frequency of cervical cancer and breast cancer screening in HIV-infected women in a county-based HIV clinic in the Western United States.
BACKGROUND
Women's primary-care services are frequently dispensed to HIV-infected women through HIV specialty clinics. Our objective was to evaluate cervical cancer and breast cancer screening practices in a county-based HIV clinic in San Mateo, California.


METHODS
This was a retrospective cohort study of medical records of HIV-infected women obtaining HIV care at this site.


RESULTS
Between January 1, 2002 and December 31, 2006, 69 women were documented to have at least 12 months of medical care at the clinic. Median followup time was 51 months. Over 253 person-years of followup, there were 656 pap smears performed per 1,000 person-years; 77.9% of women had at least one Pap smear during the study time period. A total of 59.5% (47/79) of normal pap smears had a followup pap smear within 18 months; 62.0% of abnormal pap smears had a followup pap smear within 12 months. A CD4 count of less than 200 cells/mm(3) was associated with not receiving a pap smear in multivariable analysis. Mammogram screening was performed on 64.7% of women aged 40 or older.


CONCLUSIONS
Based on the results of this study, the majority of HIV-infected women at this clinic received cervical and breast cancer screening at some point during their care. Only two-thirds of abnormal pap smear results had followup pap smear screening within a year. With the increased risk of cervical cancer in HIV-infected women, efforts should be made to promote cervical cancer screening, particularly in high-risk women.
Rahangdale
Lisa
L
Department of Obstetrics and Gynecology, Stanford University, Palo Alto, California, USA. Lisar9@med.unc.edu
Sarnquist
Clea
C
Yavari
Azita
A
Blumenthal
Paul
P
Israelski
Dennis
D
D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000628:therapy; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D008499:Medical Records; D008875:Middle Aged; D065006:Papanicolaou Test; D017064:Process Assessment, Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000523:psychology / Q000706:statistics & numerical data*; D016387:Women's Health; D055815:Young Adult