Cancer burden among HIV-positive persons in Nigeria: preliminary findings from the Nigerian AIDS-cancer match study

Akarolo-Anthony, Sally; Maso, Luigino Dal; Igbinoba, Festus; Mbulaiteye, Sam M.; Adebamowo, Clement

doi:10.1186/1750-9378-9-1

Cited by 63 publications

(65 citation statements)

References 31 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This difference with the developed world may be as a result of differences in the prevalence of risk factors for cervical cancer such as early age at first intercourse [28], total number of lifetime sexual partners, sexual practices [29], and early age at first pregnancy [28]. The widespread availability of population based screening programs for cervical cancer in developed countries has also contributed to reduced incidence while HIV infection in Africa is contributing to increased incidence [30,31]. …”

Section: Discussionmentioning

confidence: 99%

“…Several studies in Nigeria have found an association between cervical cancer and HIV [47,55]. A registry linkage study in Nigeria reported a twofold higher risk of cervical cancer in people living with HIV/AIDS [31]. A recent systematic review and meta-analysis revealed an excess risk of anal cancer among men who have sex with men (MSM), particularly among those who were HIV positive [56].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The burden of HPV associated cancers in two regions in Nigeria 2012–2014

Jedy‐Agba

Dareng

Adebamowo

et al. 2016

Cancer Epidemiology

View full text Add to dashboard Cite

Introduction HPV attributable cancers are the second most common infection-related cancers worldwide, with much higher burden in less developed regions. There are currently no country-specific estimates of the burden of these cancers in Nigeria just like many other low and middle income countries. Methods In this study, we quantified the proportion of the cancer burden in Nigeria that is attributable to HPV infection from 2012 to 2014 using HPV prevalence estimated from previous studies and data from two population based cancer registries (PBCR) in Nigeria. We considered cancer sites for which there is strong evidence of an association with HPV infection based on the International Agency for Research on Cancer (IARC) classification. We obtained age and sex-specific estimates of incident cancers and using the World Standard Population, we derived age standardized incidence (ASR) rates for each cancer type by categories of sex, and estimated the population attributable fractions (PAF). Results The two PBCR reported 4336 new cancer cases from 2012 to 2014. Of these, 1627 (37.5%) were in males and 2709 (62.5%) in females. Some 11% (488/4336) of these cancers were HPV associated; 2% (38/1627) in men and 17% (450/2709) in women. Of the HPV associated cancers, 7.8% occurred in men and 92.2% in women. The ASRs for HPV associated cancers was 33.5 per 100,000; 2.3 and 31.2 per 100,000 in men and women respectively. The proportion of all cancers attributable to HPV infection ranged from 10.2 to 10.4% (442–453 of 4336) while the proportion of HPV associated cancers attributable to HPV infection ranged from 90.6% to 92.8% (442–453 of the 488 cases). In men, 55.3% to 68.4% of HPV associated cancers were attributable to HPV infection compared to 93.6% to 94.8% in women. The combined ASR for HPV attributable cancers ranged from 31.0 to 31.7 per 100,000. This was 1.4 to 1.7 per 100,000 in men and 29.6 to 30.0 per 100,000 in women. In women, cervical cancer (n = 392, ASR 28.3 per 100,000) was the commonest HPV attributable cancer, while anal cancer (n = 21, ASR 1.2 per 100,000) was the commonest in men. Conclusions HPV attributable cancers constitute a substantial cancer burden in Nigerian women, much less so in men. A significant proportion of cancers in Nigerian women would be prevented if strategies such as HPV DNA based screening and HPV vaccination are implemented.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The burden of HPV associated cancers in two regions in Nigeria 2012–2014

Jedy‐Agba

Dareng

Adebamowo

et al. 2016

Cancer Epidemiology

View full text Add to dashboard Cite

show abstract

“…6,7,15,52 These studies could be conducted using the well-established HIV/AIDS–cancer record linkage methodology or via cohort or cross-sectional studies. 66-69 Etiological studies should also shed light on the interactions between different viral agents and other environmental factors on cancer development in this setting. This may be particularly relevant to childhood cancers.…”

Section: Research Priorities and Challengesmentioning

confidence: 99%

Challenges in the Detection, Prevention, and Treatment of HIV-Associated Malignancies in Low- and Middle-Income Countries in Africa

Adebamowo¹,

Casper

Bhatia

et al. 2014

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Cancers associated with immunosuppression and infections have long been recognized as a major complication of HIV/AIDS. More recently, persons living with HIV are increasingly diagnosed with a wider spectrum of HIV-associated malignancies (HIVAM) as they live longer on combination antiretroviral therapy. This has spurred research to characterize the epidemiology and determine the optimal management of HIVAM with a focus on low-and middle-income countries (LMICs). Given background coinfections, environmental exposures, host genetic profiles, antiretroviral therapy usage, and varying capacities for early diagnosis and treatment, one can expect the biology of cancers in HIV-infected persons in LMICs to have a significant impact on chronic HIV care, as is now the case in high-income countries. Thus, new strategies must be developed to effectively prevent, diagnose, and treat HIVAM in LMICs; provide physical/clinical infrastructures; train the cancer and HIV workforce; and expand research capacity—particularly given the challenges posed by the limitations on available transportation and financial resources and the population’s general rural concentration. Opportunities exist to extend resources supported by the President’s Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis, and Malaria to improve the health-care infrastructure and train the personnel required to prevent and manage cancers in persons living with HIV. These HIV chronic care infrastructures could also serve cancer patients regardless of their HIV status, facilitating long-term care and treatment for persons who do not live near cancer centers, so that they receive the same degree of care as those receiving chronic HIV care today.

show abstract

“…17,18 To inform cervical cancer screening programs for HIV-positive women in South Africa, data on ICC burden, associated risk factors, and the effect of screening programs on ICC risk in this specific population are needed. Whereas some ICC incidence rate estimates are available for HIV-positive women in sub-Saharan Africa, ranging from 8/100,000 pys to 259/100,000 pys, 19–22 data on risk factors and the effect of cervical cancer screening on ICC risk are scarce for the African setting. Studies examining the effect of cervical cancer screening at the patient-level often do not have enough power to detect changes in ICC incidence rates.…”

Section: Introductionmentioning

confidence: 99%

Cervical cancer risk and impact of Pap‐based screening in HIV‐positive women on antiretroviral therapy in Johannesburg, South Africa

et al. 2017

View full text Add to dashboard Cite

Data on invasive cervical cancer (ICC) incidence in HIV-positive women and the effect of cervical cancer screening in sub-Saharan Africa are scarce. We estimated i) ICC incidence rates in women (≥18 years) who initiated antiretroviral therapy (ART) at the Themba Lethu Clinic (TLC) in Johannesburg, South Africa, between 2004–2011; and ii) the effect of a Pap-based screening program. We included 10,640 women; median age at ART initiation: 35 years (interquartile range [IQR] 30–42), median CD4 count at ART initiation: 113 cells/μl (IQR 46–184). During 27,257 person-years (pys), 138 women were diagnosed with ICC; overall incidence rate: 506/100,000 pys (95% CI 428–598). The ICC incidence rate was highest (615/100,000 pys) in women who initiated ART before cervical cancer screening became available in 04/2005, and was lowest (260/100,000 pys) in women who initiated ART from 01/2009 onwards when the cervical cancer screening program and access to treatment of cervical lesions was expanded (adjusted hazard ratio [aHR] 0.42, 95% confidence interval [CI] 0.20–0.87). Advanced HIV/AIDS stage (4 versus 1, aHR 1.95, 95% CI 1.17–3.24) and middle age at ART initiation (36–45 versus 18–25 years, aHR 2.51, 95% CI 1.07–5.88) were risk factors for ICC. The ICC incidence rate substantially decreased with the implementation of a Pap-based screening program and improved access to treatment of cervical lesions. However, the risk of developing ICC after ART initiation remained high. To inform and improve ICC prevention and care for HIV-positive women in sub-Saharan Africa, implementation and monitoring of cervical cancer screening programs are essential.

show abstract

Cancer burden among HIV-positive persons in Nigeria: preliminary findings from the Nigerian AIDS-cancer match study

Cited by 63 publications

References 31 publications

The burden of HPV associated cancers in two regions in Nigeria 2012–2014

The burden of HPV associated cancers in two regions in Nigeria 2012–2014

Challenges in the Detection, Prevention, and Treatment of HIV-Associated Malignancies in Low- and Middle-Income Countries in Africa

Cervical cancer risk and impact of Pap‐based screening in HIV‐positive women on antiretroviral therapy in Johannesburg, South Africa

Contact Info

Product

Resources

About