Daijiworld Media Network - Geneva

Geneva, Mar 4: Women living with HIV face a significantly higher risk of cervical cancer and recurrent human papillomavirus (HPV) infections compared to women without HIV, according to a large systematic review that has helped shape global screening recommendations.

The review analysed more than 300 studies published between January 1, 2012 and October 13, 2019, focusing on original data related to cervical precancer and cancer outcomes in women living with HIV.

Researchers compiled data from over 72,300 women across seven countries — Burkina Faso, Cameroon, India, Kenya, South Africa, Thailand and the United States — including more than 12,500 women living with HIV.

Using random-effects models, scientists calculated predicted probabilities of cervical cancer screening outcomes by age, HIV status and antiretroviral therapy status.

Among girls and young women aged 15–19, the pooled predicted probability of cervical intraepithelial neoplasia grade 2 or 3 (CIN2/CIN3) was approximately 6%. However, the risk rose sharply in women living with HIV aged 20–24, reaching about 32.4%.

The upward trend continued with age: around 42.1% in women aged 25–29, 50.3% in 30–34-year-olds, 47% in 35–39-year-olds, 49% in 40–44-year-olds, 58.1% in 45–49-year-olds and 55.3% among women aged 50 and above.

Invasive cervical cancer was found to be relatively uncommon before the age of 30, but researchers observed a clear age-related rise in high-grade precancerous lesions (CIN2 and CIN3) among women living with HIV.

The findings contributed to updated recommendations by the World Health Organization (WHO), advising that cervical cancer screening for women living with HIV should begin at age 25, with repeat screening every three to five years.

In November 2020, WHO Director-General Tedros Adhanom Ghebreyesus launched a global strategy aimed at eliminating cervical cancer as a public health problem.

The strategy set ambitious 2030 targets: 90% of girls to be fully vaccinated with the HPV vaccine by age 15, 70% of women to be screened using a high-performance test by ages 35 and again by 45, and 90% of women diagnosed with cervical disease to receive appropriate treatment.

Health experts say early screening, HPV vaccination and timely treatment remain crucial pillars in reducing the burden of cervical cancer, particularly among women living with HIV who face disproportionately higher risks.