ArticleBMC cancer2015
The burden of cervical pre-cancer and cancer in HIV positive women in Zambia: a modeling study.
Article in BMC cancer, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Pooled it
- Cisplatin and radiation therapy in HIV-positive women with locally advanced cervical cancer in sub-Saharan Africa: A phase II study of the AIDS malignancy consortium.Gynecologic oncology · 2019Trial
- Nurse-led visual triage against histopathology in a real-world low-resource setting cervical cancer prevention program.Gynecologic oncology reports · 2026Article
- Prevalence and predictors of cervical lesions among women on ART in the Awi Zone, Northwest Ethiopia: facility-based cross-sectional study.BMC women's health · 2025Article
- Mapping the cancer research landscape across Zambia: evidence to support national cancer control planning.Ecancermedicalscience · 2025Review
- Precancerous cervical lesions and associated factors among women on antiretroviral therapy at Dukem Health Center, Central Ethiopia: A cross-sectional study.Health science reports · 2024Article
- Unraveling cervical cancer screening dilemmas: histopathological insights from VIA and LEEP at bugando medical centre, Mwanza.BMC cancer · 2024Article
- Preferences for pre-exposure prophylaxis delivery among HIV-negative pregnant and breastfeeding women in Zambia: evidence from a discrete choice experiment.Frontiers in reproductive health · 2024Article
- Validation in Zambia of a cervical screening strategy including HPV genotyping and artificial intelligence (AI)-based automated visual evaluation.Infectious agents and cancer · 2023Article
- Effects of HIV infection on metastatic cervical cancer and age at diagnosis among patients in Lusaka, Zambia.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2022Article
- Smartphone-Based Visual Inspection with Acetic Acid: An Innovative Tool to Improve Cervical Cancer Screening in Low-Resource Setting.Healthcare (Basel, Switzerland) · 2022Review
- Precancerous Cervical Lesion Among Adult Women With Human Immune Deficiency Virus on Anti Retroviral Therapy At Saint Peter Specialized Hospital, Ethiopia: A Hospital-Based Cross-Sectional Study.Frontiers in oncology · 2022Article
- Mapping Evidence on the Burden of Breast, Cervical, and Prostate Cancers in Sub-Saharan Africa: A Scoping Review.Frontiers in public health · 2022Article
- Comparison of a U.S. and Zambian Ob/Gyn Residency Training Programme.Ecancermedicalscience · 2022Article
- Screening test accuracy to improve detection of precancerous lesions of the cervix in women living with HIV: a study protocol.BMJ open · 2020Article
- Retrospective Review of Loop Electrosurgical Excision Procedure (LEEP) Outcomes at a Tertiary Hospital in Zambia.Obstetrics and gynecology international · 2020Article
- Differences in Cervical Cancer Screening Knowledge and Practices by HIV Status and Geographic Location: Implication for Program Implementation in Zambia.African journal of reproductive health · 2018Article
- Demonstration of an algorithm to overcome health system-related barriers to timely diagnosis of breast diseases in rural Zambia.PloS one · 2018Article
- Use of thermo-coagulation as an alternative treatment modality in a 'screen-and-treat' programme of cervical screening in rural Malawi.International journal of cancer · 2016Article
- Clinical Performance Validation of 4 Point-of-Care Cervical Cancer Screening Tests in HIV-Infected Women in Zambia.Journal of lower genital tract disease · 2016Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundHIV infection is associated with a higher incidence of precancerous cervical lesions and their progression to invasive cervical cancer (ICC). Zambia is a global epicenter of HIV and ICC, yet the overall burden of cervical pre-cancer [cervical intraepithelial neoplasia 3 (CIN3)] and ICC among its HIV positive adult female population is unknown. The objective of this study was to determine the burden of cervical disease among HIV positive women in Zambia by estimating the number with CIN3 and ICC.
methodsWe conducted a cross-sectional study among 309 HIV positive women attending screening in Lusaka (Zambia's most populated province) to measure the cervical disease burden by visual inspection with acetic acid enhanced by digital cervicography (DC), cytology, and histology. We then used estimates of the prevalence of CIN3 and ICC from the cross-sectional study and Spectrum model-based estimates for HIV infection among Zambian women to estimate the burden of CIN3 and ICC among HIV positive women nationally.
resultsOver half (52 %) of the study participants screened positive by DC, while 45 % had cytologic evidence of high grade squamous intraepithelial lesions (SIL) or worse. Histopathologic evaluation revealed that 20 % of women had evidence of CIN2 or worse, 11 % had CIN3 or worse, and 2 % had ICC. Using the Spectrum model, we therefore estimate that 34,051 HIV positive women in Zambia have CIN3 and 7,297 have ICC.
conclusionsThe DC, cytology, and histology results revealed a large cervical disease burden in this previously unscreened HIV positive population. This very large burden indicates that continued scale-up of cervical cancer screening and treatment is urgently needed.
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