ArticleJournal of acquired immune deficiency syndromes (1999)2015
Implementation and Operational Research: Age Distribution and Determinants of Invasive Cervical Cancer in a "Screen-and-Treat" Program Integrated With HIV/AIDS Care in Zambia.
Article in Journal of acquired immune deficiency syndromes (1999), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 25 citations in OpenAlex.
- Trial
- Primary Tumors of the Brain and Central Nervous System in Adults and Children in Sub-Saharan Africa: Protocol for a Scoping Review.JMIR research protocols · 2025Article
- Mapping the cancer research landscape across Zambia: evidence to support national cancer control planning.Ecancermedicalscience · 2025Review
- PAP Test Versus Colposcopy for Cervical Cancer Screening in HIV-Seropositive Women: A Case-Control Study.Journal of obstetrics and gynaecology of India · 2024Article
- Article
- Mapping Evidence on the Burden of Breast, Cervical, and Prostate Cancers in Sub-Saharan Africa: A Scoping Review.Frontiers in public health · 2022Article
- Association of HIV status and treatment characteristics with VIA screening outcomes in Malawi: A retrospective analysis.PloS one · 2022Article
- Comparison of a U.S. and Zambian Ob/Gyn Residency Training Programme.Ecancermedicalscience · 2022Article
- Cervical cancer in women living in South Africa: a record linkage study of the National Health Laboratory Service and the National Cancer Registry.Ecancermedicalscience · 2022Article
- Cervical cancer prevention and control in women living with human immunodeficiency virus.CA: a cancer journal for clinicians · 2021Review
- The Pattern of Cervical Cancer according to HIV Status in Yaoundé, Cameroon.Obstetrics and gynecology international · 2021Article
- HIV and development of epithelial cell abnormalities in women with prior normal cervical cytology in Nigeria.Infectious agents and cancer · 2020Article
- HIV status, age at cervical Cancer screening and cervical cytology outcomes in an opportunistic screening setting in Nigeria: a 10-year Cross sectional data analysis.Infectious agents and cancer · 2019Article
- Association between patient-reported HIV status and provider recommendation for screening in an opportunistic cervical Cancer screening setting in Jos, Nigeria.BMC health services research · 2018Article
- Barriers and Challenges to Treatment Alternatives for Early-Stage Cervical Cancer in Lower-Resource Settings.Journal of global oncology · 2017Review
- HIV-associated malignancies in sub-Saharan Africa: progress, challenges, and opportunities.Current opinion in HIV and AIDS · 2017Review
- 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
- Cervical cancer screening - The challenges of complete pathways of care in low-income countries: Focus on Malawi.Women's health (London, England)Review
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundCervical cancer screening efforts linked to HIV/AIDS care programs are being expanded across sub-Saharan Africa. Evidence on the age distribution and determinants of invasive cervical cancer (ICC) cases detected in such programs is limited.
methodsWe analyzed program operations data from the Cervical Cancer Prevention Program in Zambia, the largest public sector programs of its kind in sub-Saharan Africa. We examined age distribution patterns by HIV serostatus of histologically confirmed ICC cases and used multivariable logistic regression to evaluate independent risk factors for ICC among younger (≤35 years) and older (>35 years) women.
resultsBetween January 2006 and April 2010, of 48,626 women undergoing screening, 571 (1.2%) were diagnosed with ICC, including 262 (46%) HIV seropositive (median age: 35 years), 131 (23%) HIV seronegative (median age: 40 years), and 178 (31%) of unknown HIV serostatus (median age: 38 years). Among younger (≤35 years) women, being HIV seropositive was associated with a 4-fold higher risk of ICC [adjusted odds ratio = 4.1 (95% confidence interval: 2.8, 5.9)] than being HIV seronegative. The risk of ICC increased with increasing age among HIV-seronegative women and women with unknown HIV serostatus, but among HIV-seropositive women, the risk peaked around age 35 and nonsignificantly declined with increasing ages. Other factors related to ICC included being married (vs. being unmarried/widowed) in both younger and older women, and with having 2+ (vs. ≤1) lifetime sexual partners among younger women.
conclusionsHIV infection seems to have increased the risk of cervical cancer among younger women in Zambia, pointing to the urgent need for expanding targeted screening interventions.
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