Cervical cancer among women with AIDS in Sao Paulo, Brazil: preliminary results
V. Pinto1, A. Miranda2, A. Coelho3, M.C. Gianna3, J. Golub4
1Ministry of Health - Brazil, STD, Aids and Hepatitis Dept, Brasília, Brazil, 2Universidade Federal do Espírito Santo, Núcleo de Doenças Infecciosas, Vitoria, Brazil, 3Health State Secretariat, STD/Aids State Program, Sao Paulo, Brazil, 4Johns Hopkins University School of Medicine, School of Medicine, Baltimore, United States
Background: Describe the prevalence and risk factors for cervical cancer in women diagnosed with AIDS attending the Reference Center for STI/AIDS in São Paulo, Brazil.
Methods: Medical record survey of women attending the Gynecology service at the Reference Center for STI/AIDS in São Paulo from June 1 2008 to May 31 2009. Information regarding demographics, behavior and clinical data were collected.
Results: Among 271 patient records reviewed, history of previous chirurgic procedure for cervical cancer was present in 22 cases (8%). Median age among cases was 41 (IQR 36-47) years and median of education was 8 (IQR 7-11) years. Median time of follow up in the service was 8 (IQR 6-12) years; 221 (82%) had less than 3 years between their last two cervical screenings. Regarding risk factors, 70 (26%) were tobacco users; 4 (2%) commercial sex workers; 145 (54%) had previous STI; 38 (14%) used illicit drugs and 10 (4%) injecting drugs. Last cervical screening revealed 217 (80%) patients with normal cytology, 29 (11%) with atypical squamous cells of undetermined significance (ASCUS/HPV), 21 (8%) low grade squamous intraepithelial lesions (SILs) and 3 (1%) high-grade SILs. The median most recent CD4 count was 494 (311-731) cells/mm3
Conclusions: These results show a high proportion of cervical cancer among women with AIDS attending the gynecology service at an STI/AIDS reference center in Sao Paulo. Cancer prevention programs exist and have been shown to be successful at avoiding disease progression. Much work remains to identify additional innovative interventions that address the social, cultural, and environmental influences of cervical cancer.
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