title: Age at diagnosis of preinvasive and invasive cervical neoplasia in South Africa: HIV-positive versus HIV-negative women.
abstract: OBJECTIVE
  Human immunodeficiency virus-positive women develop invasive cervical cancer at a significantly earlier age than seronegative women. It is hypothesized that this might result from shorter preinvasive stages.
  
  
  METHODS
  Prospective observational study of histologically diagnosed 398 low-grade (LGSIL), 738 high-grade intraepithelial lesions (HGSIL), and 1048 invasive cancers (IC) in a black South African population. The study comprised of 493 (22.6%) seropositive women and 1691 (77.4%) seronegative women who served as the controls. All were subdivided into 5-years age bands.
  
  
  RESULTS
  The mean age at diagnosis of LGSIL and HGSIL was similar in the cases (t = 0.7; P = 0.49) and the controls (t = 1.2; P = 0.22). The mean age at diagnosis of IC was significantly younger in the HIV-seropositive women than in the HIV-seronegative women (t = 14.0; P < 0.0001). The relative age distribution curves of LGSIL, HGSIL, and IC evolved close to each other in the cases. In the seronegative women, there was an 18-year lag between the peak age distribution of HGSIL and IC.
  
  
  CONCLUSIONS
  Our data support the hypothesis of a shorter preinvasive stage in HIV-positive women.
authors.affiliation: University of Limpopo, Polokwane, South Africa. ljfvanbo@lantic.net
authors.forename: Louis-Jacques Jean
authors.initials: LJ
authors.lastname: van Bogaert
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D011230:Precancerous Conditions / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D013019:South Africa; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000175:diagnosis*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000175:diagnosis*