title: Characteristics and geographic distribution of HIV-positive women diagnosed with cervical cancer in Dar es Salaam, Tanzania.
abstract: Cervical cancer is the leading incident cancer and the main cause of cancer-related mortality among women in sub-Saharan Africa. Furthermore, HIV-infected women are at a higher risk of developing cervical cancer than HIV-negative women. The purpose of this study was to distinguish differences in characteristics of HIV-positive and HIV-negative patients with cervical cancer in Dar es Salaam, Tanzania. The HIV status of cervical cancer patients diagnosed and/or treated at Ocean Road Cancer Institute in Dar es Salaam, Tanzania, during the period 2007-2011 was abstracted from the medical records. Additional abstracted information included patient's name, age, place of residence, occupation, education, marital status, age at marriage, gravidity, and screening clinic visit results. Ocean Road Cancer Institute patients came from two sources: the screening clinic followed by treatment clinic or the treatment clinic without prior screening. HIV-positive and HIV-negative patients were compared regarding the above-listed clinical and epidemiologic factors. Multivariable analysis was also performed to assess the risk factors associated with cervical cancer treatment without prior screening at Ocean Road Cancer Institute. HIV-positive cervical cancer patients tended to be younger, with higher education and lower parity. Patients screened for cervical cancer prior to treatment were more likely to be HIV-positive (OR: 2.09, 95% CI: 1.36, 3.21), less likely to have higher disease stages (OR: 0.64, 95% CI: 0.43, 0.94), and less likely to reside outside of Dar es Salaam (OR: 0.44, 95% CI: 0.30, 0.65). Screening for cervical cancer at Ocean Road Cancer Institute is utilised by more HIV-positive patients from Dar es Salaam. Future studies should focus on identifying the reasons for lower utilisation of screening by HIV-negative patients and patients from other distant rural regions in Tanzania.
authors.affiliation: Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Lovgren
authors.affiliation: Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA amr.soliman@unmc.edu.
authors.forename: Amr S
authors.initials: AS
authors.lastname: Soliman
authors.affiliation: Ocean Road Cancer Institute (ORCI), Dar es Salaam, Tanzania.
authors.forename: Twalib
authors.initials: T
authors.lastname: Ngoma
authors.affiliation: Ocean Road Cancer Institute (ORCI), Dar es Salaam, Tanzania.
authors.forename: Crispin
authors.initials: C
authors.lastname: Kahesa
authors.affiliation: Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Meza
mesh_terms: D000328:Adult; D017677:Age Distribution; D055088:Early Detection of Cancer; D005260:Female; D015658:HIV Infections / Q000150:complications; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D013636:Tanzania / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology
keywords: AIDS; HIV; HPV; Tanzania; cervical cancer; screening; women