Cancer treatment and survival among cervical cancer patients living with or without HIV in South Africa
Objective: To compare cancer treatment and all-cause mortality between HIV-positive and HIV-negative cervical cancer patients in South Africa. Methods: We assessed cancer treatment and all-cause mortality in HIV-positive and HIV-negative cervical cancer patients who received cancer treatment within...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Gynecologic Oncology Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578922001497 |
| _version_ | 1811239530441736192 |
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| author | Yannick Q. Turdo Yann Ruffieux Tebatso M.G. Boshomane Hannes Mouton Katayoun Taghavi Andreas D. Haas Matthias Egger Gary Maartens Eliane Rohner |
| author_facet | Yannick Q. Turdo Yann Ruffieux Tebatso M.G. Boshomane Hannes Mouton Katayoun Taghavi Andreas D. Haas Matthias Egger Gary Maartens Eliane Rohner |
| author_sort | Yannick Q. Turdo |
| collection | DOAJ |
| description | Objective: To compare cancer treatment and all-cause mortality between HIV-positive and HIV-negative cervical cancer patients in South Africa. Methods: We assessed cancer treatment and all-cause mortality in HIV-positive and HIV-negative cervical cancer patients who received cancer treatment within 180 days of diagnosis using reimbursement claims data from a private medical insurance scheme in South Africa between 01/2011 and 07/2020. We assessed treatment provision using logistic regression and factors associated with all-cause mortality using Cox regression. We assigned missing values for histology and ethnicity using multiple imputation. Results: Of 483 included women, 136 (28 %) were HIV-positive at cancer diagnosis (median age: 45.7 years), and 347 (72 %) were HIV-negative (median age: 54.1 years). Among 285 patients with available ICD-O-3 morphology claims codes, the proportion with cervical adenocarcinoma was substantially lower in HIV-positive (4 %) than in HIV-negative patients (26 %). Most HIV-positive patients (67 %) were on antiretroviral therapy at cancer diagnosis. HIV-positive patients were more likely to receive radiotherapy (adjusted odds ratio [aOR] 1.90, 95 % confidence interval [CI] 1.05–3.45) or chemotherapy (aOR 2.02, 95 %CI 0.92–4.43) and less likely to undergo surgery (aOR 0.53, 95 %CI 0.31–0.90) than HIV-negative patients. HIV-positive patients were at a higher risk of death from all causes than HIV-negative patients (adjusted hazard ratio 1.52, 95 %CI 1.06–2.19). Other factors associated with higher all-cause mortality included age > 60 years and metastases at diagnosis. Conclusions: HIV-positive cervical cancer patients in South Africa had higher all-cause mortality than HIV-negative patients which could be explained by differences in tumour progression, clinical care, and HIV-specific mortality. |
| first_indexed | 2024-04-12T13:02:26Z |
| format | Article |
| id | doaj.art-5d1ec03ebbb14ea98b865d20e20b3c90 |
| institution | Directory Open Access Journal |
| issn | 2352-5789 |
| language | English |
| last_indexed | 2024-04-12T13:02:26Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj.art-5d1ec03ebbb14ea98b865d20e20b3c902022-12-22T03:32:08ZengElsevierGynecologic Oncology Reports2352-57892022-10-0143101069Cancer treatment and survival among cervical cancer patients living with or without HIV in South AfricaYannick Q. Turdo0Yann Ruffieux1Tebatso M.G. Boshomane2Hannes Mouton3Katayoun Taghavi4Andreas D. Haas5Matthias Egger6Gary Maartens7Eliane Rohner8Institute of Social and Preventive Medicine, University of Bern, Bern, SwitzerlandInstitute of Social and Preventive Medicine, University of Bern, Bern, SwitzerlandDepartment of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South AfricaDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South AfricaInstitute of Social and Preventive Medicine, University of Bern, Bern, SwitzerlandInstitute of Social and Preventive Medicine, University of Bern, Bern, SwitzerlandInstitute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South AfricaDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South AfricaInstitute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Corresponding author at: Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland.Objective: To compare cancer treatment and all-cause mortality between HIV-positive and HIV-negative cervical cancer patients in South Africa. Methods: We assessed cancer treatment and all-cause mortality in HIV-positive and HIV-negative cervical cancer patients who received cancer treatment within 180 days of diagnosis using reimbursement claims data from a private medical insurance scheme in South Africa between 01/2011 and 07/2020. We assessed treatment provision using logistic regression and factors associated with all-cause mortality using Cox regression. We assigned missing values for histology and ethnicity using multiple imputation. Results: Of 483 included women, 136 (28 %) were HIV-positive at cancer diagnosis (median age: 45.7 years), and 347 (72 %) were HIV-negative (median age: 54.1 years). Among 285 patients with available ICD-O-3 morphology claims codes, the proportion with cervical adenocarcinoma was substantially lower in HIV-positive (4 %) than in HIV-negative patients (26 %). Most HIV-positive patients (67 %) were on antiretroviral therapy at cancer diagnosis. HIV-positive patients were more likely to receive radiotherapy (adjusted odds ratio [aOR] 1.90, 95 % confidence interval [CI] 1.05–3.45) or chemotherapy (aOR 2.02, 95 %CI 0.92–4.43) and less likely to undergo surgery (aOR 0.53, 95 %CI 0.31–0.90) than HIV-negative patients. HIV-positive patients were at a higher risk of death from all causes than HIV-negative patients (adjusted hazard ratio 1.52, 95 %CI 1.06–2.19). Other factors associated with higher all-cause mortality included age > 60 years and metastases at diagnosis. Conclusions: HIV-positive cervical cancer patients in South Africa had higher all-cause mortality than HIV-negative patients which could be explained by differences in tumour progression, clinical care, and HIV-specific mortality.http://www.sciencedirect.com/science/article/pii/S2352578922001497Cervical cancerHIV/AIDSSurvivalSouth Africa |
| spellingShingle | Yannick Q. Turdo Yann Ruffieux Tebatso M.G. Boshomane Hannes Mouton Katayoun Taghavi Andreas D. Haas Matthias Egger Gary Maartens Eliane Rohner Cancer treatment and survival among cervical cancer patients living with or without HIV in South Africa Gynecologic Oncology Reports Cervical cancer HIV/AIDS Survival South Africa |
| title | Cancer treatment and survival among cervical cancer patients living with or without HIV in South Africa |
| title_full | Cancer treatment and survival among cervical cancer patients living with or without HIV in South Africa |
| title_fullStr | Cancer treatment and survival among cervical cancer patients living with or without HIV in South Africa |
| title_full_unstemmed | Cancer treatment and survival among cervical cancer patients living with or without HIV in South Africa |
| title_short | Cancer treatment and survival among cervical cancer patients living with or without HIV in South Africa |
| title_sort | cancer treatment and survival among cervical cancer patients living with or without hiv in south africa |
| topic | Cervical cancer HIV/AIDS Survival South Africa |
| url | http://www.sciencedirect.com/science/article/pii/S2352578922001497 |
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