Disparities in human papillomavirus–related cancer incidence and survival among human immunodeficiency virus–infected Hispanics living in the United States

Abstract

Background Human papillomavirus (HPV) causes 10% of cancers among human immunodeficiency virus (HIV)–infected people in the United States. Because Hispanics are disproportionally affected by the HIV epidemic and by infection‐related cancers, this study compared incidence rates for HPV‐related cancers and survival between Hispanics and non‐Hispanic whites (NHWs) and non‐Hispanic blacks (NHBs) in the HIV‐infected US population. Methods Based on data from the HIV/AIDS Cancer Match Study, standardized incidence ratios (SIRs) were used to estimate cancer risk in HIV‐infected Hispanics and the general US Hispanic population. Among HIV‐infected people, cancer rates were compared with incidence rate ratios (IRRs), and survival was compared with hazard ratios between Hispanics and NHWs and NHBs. Results Five hundred two HPV‐related cancers occurred in 864,067 person‐years of follow‐up among HIV‐infected Hispanics. Except for oropharyngeal cancer, the risk of HPV‐related cancers was higher among HIV‐infected Hispanics than in the general population (SIR range, 3.59 [cervical cancer] to 18.7 [anal cancer in men]). Among HIV‐infected females, Hispanics had higher cervical cancer rates than NHWs (IRR, 1.70; 95% confidence interval [CI], 1.19‐2.43) but lower vulvar cancer rates than NHWs (IRR, 0.40; 95% CI, 0.24‐0.67) and NHBs (IRR, 0.62; 95% CI, 0.41‐0.95). Among HIV‐infected males, Hispanics had higher penile cancer rates than NHWs (IRR, 2.60; 95% CI, 1.36‐4.96) but lower anal cancer rates than NHWs (IRR, 0.54; 95% CI, 0.46‐0.63) and NHBs (IRR, 0.65; 95% CI, 0.56‐0.77). Among HIV‐infected Hispanics, 5‐year survival was greater than 50% across HPV‐related cancer types, with no major differences by racial/ethnic group. Conclusions HIV‐infected Hispanics have an elevated risk for HPV‐related cancers. Similarly to the general population, HIV‐infected Hispanics have higher rates of cervical and penile cancer than NHWs and NHBs. HPV vaccination should be promoted among HIV‐infected individuals to reduce the burden of HPV‐related cancers.

Testing Messages on Facebook to Promote Use of an HPV Educational Web-Intervention

“…Although rates of HPV infection are similar across nearly all race and ethnicity groups, there are significant disparities in HPV-associated cancers among Latinx. For example, Latinas have the highest risk of developing cervical cancer when compared to all other US population groups-similarly, Latinos have the highest risk of developing penile cancer (1,(7)(8)(9)(10). Additionally, Latinx experience higher rates of other HPV-related illnesses like genital warts, abnormal Pap smears, anal cancer, and oropharyngeal cancer (6).…”

New Insights into the Epidemiology of Vulvar Cancer: Systematic Literature Review for an Update of Incidence and Risk Factors

“…The number of original articles selected was 63. Six more original articles were identified through snowballing for a total of 69 articles [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ,…”

“…An increased risk of VC among HIV-infected Hispanic women was reported by a large cohort study from the US [ 66 ], which compared Hispanic patients with the general Hispanic population. The SIR was 9.03.…”

Impact of healthcare access and HIV testing on utilisation of cervical cancer screening among US women at high risk of HIV infection: cross-sectional analysis of 2016 BRFSS data

“…Fourth, since BRFSS is not specifically designed as a survey for cervical cancer prevention and lacks detailed descriptions of screening techniques, women without relevant knowledge regarding cervical cancer might not have answered the question accurately. Fifth, because the study population consisted of predominantly white and insured women, the sample may be less representative of women at increased risk of HIV infection or cervical cancer in the USA 40. Finally, current HIV infection status and antiretroviral therapy (ART) use can be very important correlates of cervical cancer screening among women at a high risk of HIV infection 30.…”