Cervical cancer screening among women living with HIV: a cross-sectional study using the baseline questionnaire data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS)

Pokomandy, Alexandra de; Burchell, Ann; Salters, Kate; Ding, Erin; O’Brien, Nadia; Bakombo, Dada Mamvula; Proulx-Boucher, Karène; Boucoiran, Isabelle; Pick, Neora; Loutfy, Mona; Kaida, Angela

doi:10.9778/cmajo.20180151

Cited by 15 publications

(15 citation statements)

References 45 publications

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“…None of the predictors examined in the present analysis was associated with undergoing follow‐up or treatment as indicated by extant clinical guidelines. Previous studies in high‐income settings have reported low CD4 cell count as a risk factor for inadequate Pap testing among women living with HIV 15‐17 ; however, none of those studies assessed the effect of CD4 cell count on adherence to follow‐up visits after high‐risk Pap smear results.…”

Section: Discussionmentioning

confidence: 99%

Mapping the cervical cancer screening cascade among women living with HIV in Johannesburg, South Africa^a

Rohner

Mulongo

Pasipamire

et al. 2020

Intl J Gynecology & Obste

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Objective: To map the cervical cancer screening cascade among women living with HIV attending a public-sector cytology screening program in Johannesburg, South Africa. Methods: We conducted a retrospective cohort study of routinely collected clinical data captured in an electronic medical record system. Women (≥18 years) living with HIV with an abnormal Pap result between January 2013 and May 2018 were included. The proportion of women who received follow-up consistent with extant clinical guidelines, stratified by their initial Pap smear result, was examined. Results: The study included 2072 women: 1384 (66.8%) with a low-risk Pap result, 681 (32.9%) with a high-risk Pap result, and 7 (0.3%) with suspected cancer. Only 174 (25.6%) women with a high-risk Pap result underwent guideline-indicated management within 18 months. Among women with a low-risk Pap result, 375 (27.1%) received follow-up within 1 year; the cumulative incidence of follow-up increased to 63.1% at 3 years. All women with suspected cancer either received a colposcopic biopsy or were referred for further treatment. Conclusion: Attrition among South African women living with HIV who attended cervical screening in an urban public-sector program was high. Developing tailored interventions to address bottlenecks in the care cascade and improve cervical screening outcomes will be central to eliminating cervical cancer.

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Section: Discussionmentioning

confidence: 99%

Mapping the cervical cancer screening cascade among women living with HIV in Johannesburg, South Africa^a

Rohner

Mulongo

Pasipamire

et al. 2020

Intl J Gynecology & Obste

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“…Other authors had far greater results than ours regarding women who had used tobacco in the past: Godfrey M.A.L et al [42] in the United Kingdom (41.9%), Pokomandy A et al [51] in Canada (54.1%); Agorastos A et al [52] in Greece (77.45%), Wudtisan J et al [35] in Thailand (26.7%) and Bogani G et al [53] in Italy (20.9%).…”

Section: Smoking Historymentioning

confidence: 47%

Epidemiological and Cytopathological Profile of Dysplastic Lesions of the Cervix in South-Kivu/Dr Congo

Nyakio¹,

Fabrice²,

Albert³

et al. 2021

OJOG

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Background: Cervical cancer is one of the most common cancers in women in the world. The recrudescence of dysplastic lesions is increasing, especially in developing countries, because of the absence of screening. The objective of this work is to determine the prevalence of dysplastic lesions of the cervix in women who are sexually active in South Kivu province. Methods: It was a cross-sectional, descriptive and analytical study of 625 women who came for gynecological consultation, all of whom had cervical-uterine Pap smears, during the period from January 1st, 2017 to December 31st, 2018 at Panzi General Referral Hospital (South Kivu, DR Congo). Data analysis was done using Epi Info software version 7. Results: The median age of the respondents was 34 years, 47.0% of them were married, and 59.0% had a low socioeconomic level. The majority had first sexual intercourse between the ages of 15 and 20 (67.5%), a number of former sexual partners estimated at 1-5 (87.8%), did not use tobacco (97.4%) and did not use contraception (78.1%). Pap smear was normal in 82.88% of cases, inflammatory in 2.4% of cases and with cytologic abnormalities in 14.72% of cases. Rates of dysplastic lesions were significantly higher among women aged ≥35 years (p = 0.0245), brides (p = 0.0183) and nulliparas (p = 0.0042). Multivariate analysis revealed the adjusted OR (95% CI) statistically insignificant (p < 0.05) for the age group, marital status and parity respondents. Conclusion: Cervical cancer How to cite this paper:

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“…8 Similarly, Canadian guidelines recommend annual pap tests for WLWH. 9 One-third of the HCWs agreed that a pap smear should be done at 21 years of age irrespective of HIV status. In this regard, the South African guidelines report that the pap smear must be done at the age of 25 years in HIV-uninfected women whilst in WLWH smears should be done at the time of testing HIV-seropositive.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Women Living with HIV who are < 21 years of age and are sexually active may have a high rate of progression of abnormal cytology. 9 Brogly and colleagues reported that 30% of adolescents had atypical squamous cells of undetermined significance (ASC-US) or greater on their first cervical pap test. 10 A small percentage of the HCWs agreed that a pap smear in WLWH is only performed after the age of 30 years, whereas the NDOH guidelines state that in WLWH pap smears should be done at the time of diagnosis of the HIV infection.…”

Section: Discussionmentioning

confidence: 99%

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Healthcare worker compliance with cervical cancer screening guidelines. An audit at district and regional level of care in the Pietermaritzburg Metropolitan area of KwaZulu-Natal

Makhubo

Naidoo

2020

Southern African Journal of HIV Medicine

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Background: In South Africa (SA) there are screening guidelines for cervical cancer in women living with HIV (WLWH). To our knowledge there is lack of data concerning the knowledge of health care workers (HCWs) about cervical cancer screening guidelines before the initiation of antiretroviral therapy (ART) in WLWH.Objectives: To investigate the knowledge and familiarity of HCWs regarding cervical cancer screening guidelines in WLWH.Methods: A cross-sectional questionnaire-based study exploring compliance with cervical cancer screening guidelines before initiating ART was conducted with 85 HCWs in the antiretroviral (ARV) clinics of a district and regional hospitals in KwaZulu-Natal, SA. Data were analysed using Stata V13 and a p-value of ≤ 0.05 was considered statistically significant.Results: Eighty-five HCWs were included in the study. Health care workers’ responses to knowledge about cervical cancer screening in WLWH were suboptimal and revealed significant gaps. Most HCWs did not know the screening intervals of WLWH. Statistically significant associations were found between an HCW’s occupation and responses to the Likert scale questions.Conclusion: Although the majority of HCWs were familiar with cervical cancer screening guidelines in WLWH, the study highlights that there are deficiencies in both knowledge and practice. Creating awareness among HCWs regarding the current methods of cervical cancer screening is a necessary to reduce morbidity and mortality from cervical cancer in WLWH.

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Cervical cancer screening among women living with HIV: a cross-sectional study using the baseline questionnaire data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS)

Cited by 15 publications

References 45 publications

Mapping the cervical cancer screening cascade among women living with HIV in Johannesburg, South Africa^a

Mapping the cervical cancer screening cascade among women living with HIV in Johannesburg, South Africa^a

Epidemiological and Cytopathological Profile of Dysplastic Lesions of the Cervix in South-Kivu/Dr Congo

Healthcare worker compliance with cervical cancer screening guidelines. An audit at district and regional level of care in the Pietermaritzburg Metropolitan area of KwaZulu-Natal

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Cervical cancer screening among women living with HIV: a cross-sectional study using the baseline questionnaire data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS)

Cited by 15 publications

References 45 publications

Mapping the cervical cancer screening cascade among women living with HIV in Johannesburg, South Africaa

Mapping the cervical cancer screening cascade among women living with HIV in Johannesburg, South Africaa

Epidemiological and Cytopathological Profile of Dysplastic Lesions of the Cervix in South-Kivu/Dr Congo

Healthcare worker compliance with cervical cancer screening guidelines. An audit at district and regional level of care in the Pietermaritzburg Metropolitan area of KwaZulu-Natal

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Product

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Mapping the cervical cancer screening cascade among women living with HIV in Johannesburg, South Africa^a

Mapping the cervical cancer screening cascade among women living with HIV in Johannesburg, South Africa^a