The prevalence of macroscopic cervical cancer in women on antiretroviral therapy in the Pietermaritzburg metropolitan area

Authors

Keywords:

macroscopic cervical cancer, antiretroviral therapy, WLWH

Abstract

Background: Women living with HIV (WLWH) are screened for cervical cancer at diagnosis or within a year of sexual debut. Our study looked at the prevalence of macroscopic invasive cervical cancer in WLWH on antiretroviral treatment (ART).

Methods: This was a descriptive retrospective chart review of WLWH on ART. The women were referred with invasive cervical cancer to the Gynaecological Oncology Unit of Greys Tertiary Hospital from January 2018 to December 2019.

Results: We reviewed 220 records. The prevalence of macroscopic invasive cervical cancer was 95%. Of these women, 151 (68.64%) did not have an initial screening test. Of all patients with cervical cancer, 129 (58.64%) were not screened in the previous three years prior to the diagnosis of cervical cancer. There were 212 (96.4%) patients on ART for more than six months. Squamous cell carcinoma made up 212 (96.36%) of the cases, five (2.27%) adenocarcinoma, and two (0.91%) adenosquamous carcinoma. Only 5% of cases were FIGO stage 1A, while the majority were locally advanced disease FIGO stage 2B and 3B (23.2% and 52.3% respectively).

Conclusion: The prevalence of macroscopic and locally advanced cervical cancer is still unacceptably high in WLWH on ART. We need to strengthen cervical cancer screening practices at all healthcare centres that are caring for WLWH in line with national guidelines.

Author Biographies

  • SK Sithole, University of KwaZulu-Natal

    Department of Obstetrics and Gynaecology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa and Greys Hospital, South Africa

  • BS Makhathini, University of KwaZulu-Natal

    Department of Obstetrics and Gynaecology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa and Greys Hospital, South Africa

  • TD Naidoo, University of KwaZulu-Natal

    Department of Obstetrics and Gynaecology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa and Greys Hospital, South Africa

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Published

2023-04-14

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Section

Original Research