Estimates of the global burden of cervical cancer associated with HIV

作者：Dominik Stelzle, Luana Fiengo Tanaka, Kuan Ken Lee, Ahmadaye Ibrahim Khalil, Iacopo Baussano, Anoop Shah, David McAllister, Sami L. Gottlieb, Stefanie J. Klug, Andrea Sylvia Winkler, Freddie Bray, Rachel Baggaley, Gary M. Clifford, Nathalie Broutet, Shona Dalal · 发表于：The Lancet Global Health · 年份：2020 · DOI：10.1016/s2214-109x(20)30459-9 · 被引用次数：966 · 研究领域：Cervical Cancer and HPV Research、Endometrial and Cervical Cancer Treatments、Viral-associated cancers and disorders

BACKGROUND: HIV enhances human papillomavirus (HPV)-induced carcinogenesis. However, the contribution of HIV to cervical cancer burden at a population level has not been quantified. We aimed to investigate cervical cancer risk among women living with HIV and to estimate the global cervical cancer burden associated with HIV. METHODS: We did a systematic literature search and meta-analysis of five databases (PubMed, Embase, Global Health [CABI.org], Web of Science, and Global Index Medicus) to identify studies analysing the association between HIV infection and cervical cancer. We estimated the pooled risk of cervical cancer among women living with HIV across four continents (Africa, Asia, Europe, and North America). The risk ratio (RR) was combined with country-specific UNAIDS estimates of HIV prevalence and GLOBOCAN 2018 estimates of cervical cancer to calculate the proportion of women living with HIV among women with cervical cancer and population attributable fractions and age-standardised incidence rates (ASIRs) of HIV-attributable cervical cancer. FINDINGS: 24 studies met our inclusion criteria, which included 236 127 women living with HIV. The pooled risk of cervical cancer was increased in women living with HIV (RR 6·07, 95% CI 4·40-8·37). Globally, 5·8% (95% CI 4·6-7·3) of new cervical cancer cases in 2018 (33 000 new cases, 95% CI 26 000-42 000) were diagnosed in women living with HIV and 4·9% (95% CI 3·6-6·4) were attributable to HIV infection (28 000 new cases, 20 0...