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Adherence to the cervical cancer screening program in women living with HIV in Denmark: comparison with the general population

BACKGROUND: Women living with HIV (WLWH) are at increased risk of invasive cervical cancer (ICC). International HIV guidelines suggest cervical screening twice the first year after HIV diagnosis and thereafter annually. Adherence to the HIV cervical screening program in Denmark is unknown. METHODS:...

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Autores principales: Thorsteinsson, Kristina, Ladelund, Steen, Jensen-Fangel, Søren, Katzenstein, Terese L, Johansen, Isik Somuncu, Pedersen, Gitte, Junge, Jette, Helleberg, Marie, Storgaard, Merete, Lebech, Anne-Mette
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025560/
https://www.ncbi.nlm.nih.gov/pubmed/24885577
http://dx.doi.org/10.1186/1471-2334-14-256
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author Thorsteinsson, Kristina
Ladelund, Steen
Jensen-Fangel, Søren
Katzenstein, Terese L
Johansen, Isik Somuncu
Pedersen, Gitte
Junge, Jette
Helleberg, Marie
Storgaard, Merete
Lebech, Anne-Mette
author_facet Thorsteinsson, Kristina
Ladelund, Steen
Jensen-Fangel, Søren
Katzenstein, Terese L
Johansen, Isik Somuncu
Pedersen, Gitte
Junge, Jette
Helleberg, Marie
Storgaard, Merete
Lebech, Anne-Mette
author_sort Thorsteinsson, Kristina
collection PubMed
description BACKGROUND: Women living with HIV (WLWH) are at increased risk of invasive cervical cancer (ICC). International HIV guidelines suggest cervical screening twice the first year after HIV diagnosis and thereafter annually. Adherence to the HIV cervical screening program in Denmark is unknown. METHODS: We studied women from a population-based, nationwide HIV cohort in Denmark and a cohort of age-matched females from the general population. Screening behaviour was assessed from 1999–2010. Adjusted odds ratios (OR’s) for screening attendance in the two cohorts and potential predictors of attendance to guidelines were estimated. Pathology specimens were identified from The Danish Pathology Data Bank. RESULTS: We followed 1143 WLWH and 17,145 controls with no prior history of ICC for 9,509 and 157,362 person-years. The first year after HIV diagnosis 2.6% of WLWH obtained the recommended two cervical cytologies. During the different calendar intervals throughout the study period between 29-46% of WLWH followed the HIV cervical screening guidelines. Adjusted OR’s of attendance to the general population screening program for WLWH aged 30, 40 and 50 years, compared to controls, were 0.69 (95% CI: 0.56-0.87), 0.67 (0.55-0.80) and 0.84 (0.61-1.15). Predictors of attendance to the HIV cervical screening program were a CD4 count > 350 cells/μL and HIV RNA < 500 copies/mL. Calendar period after 2002 and HIV RNA < 500 copies/mL predicted attendance to the general population cervical screening program. CONCLUSIONS: The majority of WLWH do not follow the HIV guidelines for cervical screening. We support the idea of cytology as part of an annual review and integration of HIV care and cervical screening in a single clinic setting.
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spelling pubmed-40255602014-05-20 Adherence to the cervical cancer screening program in women living with HIV in Denmark: comparison with the general population Thorsteinsson, Kristina Ladelund, Steen Jensen-Fangel, Søren Katzenstein, Terese L Johansen, Isik Somuncu Pedersen, Gitte Junge, Jette Helleberg, Marie Storgaard, Merete Lebech, Anne-Mette BMC Infect Dis Research Article BACKGROUND: Women living with HIV (WLWH) are at increased risk of invasive cervical cancer (ICC). International HIV guidelines suggest cervical screening twice the first year after HIV diagnosis and thereafter annually. Adherence to the HIV cervical screening program in Denmark is unknown. METHODS: We studied women from a population-based, nationwide HIV cohort in Denmark and a cohort of age-matched females from the general population. Screening behaviour was assessed from 1999–2010. Adjusted odds ratios (OR’s) for screening attendance in the two cohorts and potential predictors of attendance to guidelines were estimated. Pathology specimens were identified from The Danish Pathology Data Bank. RESULTS: We followed 1143 WLWH and 17,145 controls with no prior history of ICC for 9,509 and 157,362 person-years. The first year after HIV diagnosis 2.6% of WLWH obtained the recommended two cervical cytologies. During the different calendar intervals throughout the study period between 29-46% of WLWH followed the HIV cervical screening guidelines. Adjusted OR’s of attendance to the general population screening program for WLWH aged 30, 40 and 50 years, compared to controls, were 0.69 (95% CI: 0.56-0.87), 0.67 (0.55-0.80) and 0.84 (0.61-1.15). Predictors of attendance to the HIV cervical screening program were a CD4 count > 350 cells/μL and HIV RNA < 500 copies/mL. Calendar period after 2002 and HIV RNA < 500 copies/mL predicted attendance to the general population cervical screening program. CONCLUSIONS: The majority of WLWH do not follow the HIV guidelines for cervical screening. We support the idea of cytology as part of an annual review and integration of HIV care and cervical screening in a single clinic setting. BioMed Central 2014-05-13 /pmc/articles/PMC4025560/ /pubmed/24885577 http://dx.doi.org/10.1186/1471-2334-14-256 Text en Copyright © 2014 Thorsteinsson et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Thorsteinsson, Kristina
Ladelund, Steen
Jensen-Fangel, Søren
Katzenstein, Terese L
Johansen, Isik Somuncu
Pedersen, Gitte
Junge, Jette
Helleberg, Marie
Storgaard, Merete
Lebech, Anne-Mette
Adherence to the cervical cancer screening program in women living with HIV in Denmark: comparison with the general population
title Adherence to the cervical cancer screening program in women living with HIV in Denmark: comparison with the general population
title_full Adherence to the cervical cancer screening program in women living with HIV in Denmark: comparison with the general population
title_fullStr Adherence to the cervical cancer screening program in women living with HIV in Denmark: comparison with the general population
title_full_unstemmed Adherence to the cervical cancer screening program in women living with HIV in Denmark: comparison with the general population
title_short Adherence to the cervical cancer screening program in women living with HIV in Denmark: comparison with the general population
title_sort adherence to the cervical cancer screening program in women living with hiv in denmark: comparison with the general population
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025560/
https://www.ncbi.nlm.nih.gov/pubmed/24885577
http://dx.doi.org/10.1186/1471-2334-14-256
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