Cervical cancer prevention and control in women living with human immunodeficiency virus

Castle, Philip E.; Einstein, Mark H.; Sahasrabuddhe, Vikrant V.

doi:10.3322/caac.21696

Cited by 122 publications

(114 citation statements)

References 287 publications

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“…Cervical cancer is the fourth most commonly diagnosed malignant neoplasm among women worldwide [ 1 ]. It was estimated that 569 847 new cervical cancer cases and 311 365 deaths occur each year [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Nomogram for Predicting Postoperative Distant Metastasis in Patients with Cervical Cancer

et al. 2022

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Background Cervical cancer is the fourth most commonly diagnosed malignant neoplasm among women worldwide. Despite improvements in treatment, the rate of postoperative metastasis remains a problem. Nomograms have been used to predict risk of tumor metastasis. We designed a nomogram to predict postoperative distant metastasis among cervical cancer patients, based on the SEER database, and estimated the performance of the nomogram by internal and external validations. Material/Methods We included 6421 participants and divided them into training (n=4495) and testing (n=1926) sets. Multivariate logistic regression was used to explore predictors. The nomogram’s predictive value was assessed by internal (testing set) and external (561 Chinese patients) validations. The receiver operating characteristic curve (ROC) was plotted, and the area under the curve (AUC) value was calculated to evaluate the nomogram’s discrimination. The nomogram’s calibration was assessed via the Hosmer-Lemeshow test and calibration curve. Results Histologic type, T stage, treatment, tumor size, and positive lymph node were identified as independent predictors of postoperative distant metastasis in surgical patients ( P <0.05). The developed nomogram had an AUC of 0.866 (95% CI: 0.844 to 0.888). The AUC and the chi-square for the Hosmer-Lemeshow test of the nomogram were 0.847 (95% CI: 0.807 to 0.888) and 11.292, respectively, ( P >0.05) in the internal validation, and were 0.626 (95% CI: 0.548 to 0.704) and 316.53, respectively, ( P <0.05) in the external validation. Conclusions Our nomogram showed a good predictive performance for postoperative distant metastasis in cervical cancer patients based on the SEER database. It remains to be determined if it is applicable to other populations.

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Section: Introductionmentioning

confidence: 99%

Development and Validation of a Nomogram for Predicting Postoperative Distant Metastasis in Patients with Cervical Cancer

et al. 2022

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“…Cervical cancer is one of the main causes of women’s cancer-related deaths worldwide ( 15 ). For cervical cancer patients, lymph nodes status is a critical predictor of survival that has been applied to guide clinical treatment ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of Novel Nomograms to Predict the Overall Survival and Cancer-Specific Survival of Cervical Cancer Patients With Lymph Node Metastasis

Liu

Wang³

et al. 2022

Front. Oncol.

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ObjectiveThe objective of this study was to establish and validate novel individualized nomograms for predicting the overall survival (OS) and cancer-specific survival (CSS) in cervical cancer patients with lymph node metastasis.MethodsA total of 2,956 cervical cancer patients diagnosed with lymph node metastasis (American Joint Committee on Cancer, AJCC N stage=N1) between 2000 and 2018 were included in this study. Univariate and multivariate Cox regression models were applied to identify independent prognostic predictors, and the nomograms were established to predict the OS and CSS. The concordance index (C-index), calibration curves, and receiver operating characteristic (ROC) curves were applied to estimate the precision and discriminability of the nomograms. Decision-curve analysis (DCA) was used to assess the clinical utility of the nomograms.ResultsTumor size, log odds of positive lymph nodes (LODDS), radiotherapy, surgery, T stage, histology, and grade resulted as significant independent predictors both for OS and CSS. The C-index value of the prognostic nomogram for predicting OS was 0.788 (95% CI, 0.762–0.814) and 0.777 (95% CI, 0.758–0.796) in the training and validation cohorts, respectively. Meanwhile, the C-index value of the prognostic nomogram for predicting CSS was 0.792 (95% CI, 0.767–0.817) and 0.781 (95% CI, 0.764–0.798) in the training and validation cohorts, respectively. The calibration curves for the nomograms revealed gratifying consistency between predictions and actual observations for both 3- and 5-year OS and CSS. The 3- and 5-year area under the curves (AUCs) for the nomogram of OS and CSS ranged from 0.781 to 0.828. Finally, the DCA curves emerged as robust positive net benefits across a wide scale of threshold probabilities.ConclusionWe have successfully constructed nomograms that could predict 3- and 5-year OS and CSS of cervical cancer patients with lymph node metastasis and may assist clinicians in decision-making and personalized treatment planning.

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“…According to the World Health Organization (WHO), 570,000 women were diagnosed with cervical cancer in 2018 worldwide, 5.8% of whom were living with HIV [ 48 ]. Indeed, a recent meta-analysis reported an increased pooled risk of cervical cancer in women living with HIV (with a risk ratio (RR) of 6.07) [ 49 ]. In addition, the incidence of anal dysplasia is also more common in PLWH, especially among MSM.…”

Section: Relationship Between Hiv and Hpvmentioning

confidence: 99%

“…Current guidelines recommend performing HPV DNA detection, Papanicolaou (Pap), or visual inspection after acetic acid (VIA) tests, although the former has become the preferred method according to the WHO [ 48 ]. Women living with HIV should be routinely screened for cervical dysplasia, especially those with low CD4 lymphocyte count or high HIV viral load [ 49 ]. Despite effective ART and adequate immunological control, women living with HIV have a higher risk of progression toward invasive carcinoma compared with those without HIV [ 103 ].…”

Section: Dysplasia Screening Programs In People Living With Hivmentioning

confidence: 99%

Update on the Epidemiological Features and Clinical Implications of Human Papillomavirus Infection (HPV) and Human Immunodeficiency Virus (HIV) Coinfection

2022

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Human papillomavirus (HPV) infection is the most common sexually transmitted infection (STI) worldwide. Although most HPV infections will spontaneously resolve, a considerable proportion of them will persist, increasing the risk of anogenital dysplasia, especially within certain populations, such as patients infected with human immunodeficiency virus (HIV). Furthermore, high-risk oncogenic HPV types (HR-HPV) are the main cause of cervix and other anogenital cancers, such as cancer of the vagina, vulva, penis, or anus. HIV and HPV coinfection is common among people living with HIV (PLWH) but disproportionally affects men who have sex with men (MSM) for whom the rate of persistent HPV infection and reinfection is noteworthy. The molecular interactions between HIV and HPV, as well as the interplay between both viruses and the immune system, are increasingly being understood. The immune dysfunction induced by HIV infection impairs the rate of HPV clearance and increases its oncogenic risk. Despite the availability of effective antiretroviral therapy (ART), the incidence of several HPV-related cancers is higher in PLWH, and the burden of persistent HPV-related disease has become a significant concern in an aging HIV population. Several public health strategies have been developed to reduce the transmission of HIV and HPV and mitigate the consequences of this type of coinfection. Universal HPV vaccination is the most effective preventive tool to reduce the incidence of HPV disease. In addition, screening programs for HPV-related cervical and vulvovaginal diseases in women are well-recognized strategies to prevent cervical cancer. Similarly, anal dysplasia screening programs are being implemented worldwide for the prevention of anal cancer among PLWH. Herein, the main epidemiological features and clinical implications of HIV and HPV coinfection are reviewed, focusing mainly on the relationship between HIV immune status and HPV-related diseases and the current strategies used to reduce the burden of HPV-related disease.

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Cervical cancer prevention and control in women living with human immunodeficiency virus

Cited by 122 publications

References 287 publications

Development and Validation of a Nomogram for Predicting Postoperative Distant Metastasis in Patients with Cervical Cancer

Development and Validation of a Nomogram for Predicting Postoperative Distant Metastasis in Patients with Cervical Cancer

Development and Validation of Novel Nomograms to Predict the Overall Survival and Cancer-Specific Survival of Cervical Cancer Patients With Lymph Node Metastasis

Update on the Epidemiological Features and Clinical Implications of Human Papillomavirus Infection (HPV) and Human Immunodeficiency Virus (HIV) Coinfection

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