title: Preventive cancer screening practices in HIV-positive patients.
abstract: As patients with HIV age, they are at risk of developing non-AIDS defining malignancies. We performed a questionnaire study to evaluate colorectal and breast cancer screening among HIV-positive and HIV-negative patients seeking care from either an integrated (HIV/primary care), nonintegrated (specialized HIV), or general internal medicine clinic between August 2010 and July 2011. We performed a logistic regression to determine the odds of cancer screening. A total of 813 surveys were collected, and 762 were included in the analysis. As much as 401 were from HIV-positive patients. Patients with HIV were less likely to be current with their colorectal cancer screening (CRCS) (54.4% versus 65.0%, p=0.009); mammography rates were 24.3% versus 62.3% if done during the past year (p<0.001), and 42.0% versus 86.7% if done during the past 5 years (p<0.001). In adjusted models, the odds of colorectal cancer screening in HIV-positive patients compared to negative controls was not statistically significant (OR 0.8; 95% CI 0.5-1.3); however, HIV-positive women remained significantly less likely to be current with breast cancer screening (BCS) whether their mammogram was completed within 1 year (OR 0.1, 95% CI 0.1-0.2) or within 5 years (OR 0.1, 95% CI 0.0-0.2). Integrated care was not associated with improved screening; however, having frequent visits to a primary care physician (PCP) increased the likelihood of getting screened. BCS was lower in HIV-positive compared to HIV-negative women. Frequent visits to a PCPs improved cancer screening.
authors.affiliation: a Division of Infectious Diseases , Temple University Hospital , Philadelphia , PA , USA.
authors.forename: Florence
authors.initials: F
authors.lastname: Momplaisir
authors.forename: Karam
authors.initials: K
authors.lastname: Mounzer
authors.forename: Judith A
authors.initials: JA
authors.lastname: Long
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis*; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated / Q000706:statistics & numerical data*; D055088:Early Detection of Cancer; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D016015:Logistic Models; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D011320:Primary Health Care; D012959:Socioeconomic Factors