A cross-sectional population-based study of breast cancer screening among women with HIV in Ontario, Canada

Kendall, Claire; Walmsley, Sharon; Lau, Cindy; Jembere, Nathaniel; Burchell, Ann; Loutfy, Mona; Raboud, Janet; Rosenes, Ron; Rourke, Sean B.; Antoniou, Tony

doi:10.9778/cmajo.20170038

Cited by 11 publications

(12 citation statements)

References 28 publications

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“…In addition, Tron and colleagues and Kendall et al identified specific barriers for screening among women living with HIV, including low educational background and low income level. 10,11 These challenges are identical to those identified in the review by Lambert et al, who studied barriers to cervical cancer screening among women with HIV. 22 Thus, social determinants of health play a major role in the receipt of cancer screening among HIV-infected women and may contribute to disparities in cancer care.…”

Section: Discussionmentioning

confidence: 60%

“…9–11 Two studies were cross-sectional, and 1 used a prospective cohort design. All 3 studies were scored as good quality.…”

Section: Resultsmentioning

confidence: 99%

“…The third study analyzed breast cancer screening among women aged 50 to 74 years in Ontario, Canada. 11 Among 623 HIV-positive women and 1,446,392 HIV-negative women, fewer HIV-positive women had breast cancer screening than HIV-negative women (50% vs 63%, respectively; P < .05).…”

Section: Breast Cancermentioning

confidence: 93%

“…9 For the remaining 2 studies, breast cancer screening was defined as biennial mammography starting at age 50 years. 10,11 All 3 studies designated women who had a screening mammogram in the 2-year timeframe surrounding the study period as being up-to-date with breast cancer screening. The studies were done in 3 different countries: the United States, France, and Canada.…”

Section: Breast Cancermentioning

confidence: 99%

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Cancer disparities in people with HIV: A systematic review of screening for non‐AIDS–defining malignancies

Corrigan

Wall

Bartlett

et al. 2019

Cancer

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BACKGROUND People with the human immunodeficiency virus (PWHIV) have improved survival because of the advent of antiretroviral therapy. Consequently, PWHIV experience higher rates of non-acquired immunodeficiency syndrome-defining malignancies (NADMs). Previous studies have demonstrated worsened cancer-specific survival in PWHIV, partly because of advanced cancer stage at diagnosis. The objective of the current systematic review was to evaluate screening disparities for NADMs among PWHIV. METHODS The PubMed, Cochrane, EMBASE, and ClinicalTrials.gov databases were searched from January 1, 1996 through April 10, 2018 to identify studies related to screening disparities for NADMs among PWHIV. Eligibility criteria included any study performed in a high-income country that compared screening for NADMs by HIV status. After title/abstract screening and full-text review, articles that met eligibility criteria were analyzed. RESULTS Of 613 unique articles identified through the search, 9 studies were analyzed. Three studies addressed breast cancer screening, 4 addressed colorectal cancer screening, and 2 addressed prostate cancer screening. Five of the reviewed studies demonstrated that PWHIV were less likely to receive indicated cancer screenings compared with the general population, whereas 3 indicated that screening proportions were higher among PWHIV, and 1 demonstrated that screening proportions were comparable. In most of the studies, PWHIV who had regular access to health care were more likely to undergo cancer screening. CONCLUSIONS The available evidence does not uniformly confirm that PWHIV are less likely to receive cancer screening. Social determinants of health (insurance status, access to health care, education, income level) were associated with the receipt of appropriate cancer screening, suggesting that these barriers need to be addressed to improve cancer screening in PWHIV.

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Section: Discussionmentioning

confidence: 60%

“…9–11 Two studies were cross-sectional, and 1 used a prospective cohort design. All 3 studies were scored as good quality.…”

Section: Resultsmentioning

confidence: 99%

Section: Breast Cancermentioning

confidence: 93%

Section: Breast Cancermentioning

confidence: 99%

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Cancer disparities in people with HIV: A systematic review of screening for non‐AIDS–defining malignancies

Corrigan

Wall

Bartlett

et al. 2019

Cancer

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“…However, in the context of the younger patient and the sub‐Saharan African setting, benign breast disease, tuberculosis and, occasionally, Kaposi sarcoma of the breast add to diagnostic challenges. Turning to higher‐income countries, attendance of breast cancer screening among WLWHA was higher than that of the general population in France, but lower in Ontario, Canada, thus a setting‐specific evaluation of early‐diagnosis interventions needed in WLWHA is warranted.…”

Section: Discussionmentioning

confidence: 99%

Breast cancer in women living with HIV: A first global estimate

McCormack

Febvey-Combes

Ginsburg

et al. 2018

Intl Journal of Cancer

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There is a growing population of older women living with HIV/AIDS (WLWHA). Breast cancer is a common cancer in women worldwide, but the global number of breast cancers in WLWHA is not known. We estimated, for each UN sub-region, the number and age distribution of WLWHA who were diagnosed with breast cancer in 2012, by combining IARC-GLOBOCAN estimates of age-country specific breast cancer incidence with corresponding UNAIDS HIV prevalence. Primary analyses assumed no HIV-breast cancer association, and a breast cancer risk reduction scenario was also considered. Among 16.0 million WLWHA aged 15+ years, an estimated 6,325 WLWHA were diagnosed with breast cancer in 2012, 74% of whom were in sub-Saharan Africa, equally distributed between Eastern, Southern and Western Africa. In most areas, 70% of HIV-positive breast cancers were diagnosed under age 50. Among all breast cancers (regardless of HIV status), HIV-positive women constituted less than 1% of the clinical burden, except in Eastern, Western and Middle Africa where they comprised 4-6% of under age 50 year old breast cancer patients, and in Southern Africa where this patient subgroup constituted 26 and 8% of breast cancers diagnosed under and over age 50 respectively. If a deficit of breast cancer occurs in WLWHA, the global estimate would reduce to 3,600. In conclusion, worldwide, the number of HIV-positive women diagnosed with breast cancer was already substantial in 2012 and with an expected increase within the next decade, early detection and treatment research targeted to this population are needed.

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