Sixfold increase in risk

December 21, 2020

A research team at the Technical University of Munich (TUM) has quantified the effects of an infection with the Human Immunodeficiency Virus (HIV) on the development of cervical cancer. Their results show that the risk of developing cervical cancer is six times higher in women who are infected with HIV. Southern and Eastern Africa are particularly affected.

According to WHO statistics, cervical cancer is the fourth most common type of cancer for women. In 2018 an estimated 570,000 women worldwide were diagnosed with cervical carcinoma, with approximately 311,000 of these women dying.

On the other hand cervical cancer, usually caused by Human Papillomavirus (HPV), is also one of the most successfully preventable and treatable types of cancer, as long as it is detected at an early stage and treated effectively.

Cervical cancer is at the same time the most frequently detected cancer for women who live with HIV, since their immune systems are weakened by the HIV infection.

The TUM School of Medicine's Center for Global Health and the Chair of Epidemiology at the TUM Department of Sport and Health Sciences have now dedicated their efforts to this relevant topic in the publication "Estimates of the Global Burden of Cervical Cancer Associated with HIV", published in the renowned journal The Lancet Global Health.

Systematic review and meta-analysis of 24 studies

The lead authors Dr. Dominik Stelzle (Center for Global Health and Chair of Epidemiology) and Dr. Luana Tanaka (Chair of Epidemiology) conducted a systematic review as well as a meta-analysis of a total of 24 studies from the years 1981 to 2016, in which 236,127 women with HIV from four continents (Africa, North America, Asia and Europe) participated.

These studies covered a total of 2,138 cervical carcinoma cases. The results were linked with data from UNAIDS on worldwide HIV infection and with data on cervical carcinoma from the International Agency for Research on Cancer (IARC), the WHO's Cancer Research Center, and then evaluated.

"Until now there have only been estimates from countries with high net income levels," says Dr. Stelzle. "That's why we looked at the figures on global incidence of cervical carcinoma in connection with an HIV infection and included estimates for countries with low net incomes. In most parts of the world the numbers are under five percent. In some countries however we're talking about well over 40 percent of cases."

Risk is six times higher for women with HIV

The objective of the study was to calculate the share of women living with HIV among the number of women with cervical cancer. The authors found that 5.8 percent of all new cervical cancer cases worldwide in the year 2018 were diagnosed for women with an HIV infection. This is equivalent to 33,000 cases a year, 85 percent of which occurred in Sub-Saharan Africa.

Furthermore, based on their results the team was able to show that women with HIV have a sixfold higher risk of developing cervical cancer than women without HIV infection.

"The association between cervical carcinoma and HIV is plausible," says Prof. Andrea S. Winkler, co-director of the Center for Global Health. "Cervical carcinomas are usually caused by infections with Human papillomavirus (HPV), which are sexually transmitted just as HIV is. Based on our results it can be assumed that an infection with HIV represents a risk factor for an infection with HPV."

Southern and eastern Afrika most affected

The regions most strongly affected are southern and eastern Africa, where respectively 63.8 percent and 27.4 percent of cervical carcinomas were diagnosed in women with an HIV infection.

"With over 75 percent, Eswatini in southern Africa is the country with the highest share of women suffering from cervical cancer in connection with an HIV infection, followed by Lesotho with 69 percent, Botswana with 67 percent, South Africa with 64 percent and Zimbabwe with 52 percent," says Dr. Tanaka.

Based on the results, the TUM authors determined that women with an HIV infection have a significantly higher risk of developing cervical cancer. They also pointed out that this means that HPV vaccinations and early-stage cervical carcinoma screenings are of particular importance, especially in the African countries south of the Sahara.

"Although cervical cancer screenings already exist in Africa, until now they have been performed primarily on women with a higher socio-economic status who could afford the screening," says Prof. Stefanie Klug, who holds the Chair of Epidemiology at TU Munich. "The goal has to be to end this dependency on economic means and to succeed in introducing free HPV vaccination for girls and screening for adult women."
-end-
The publication is the result of a collaborative effort by the Center for Global Health (Department of Neurology) of the TUM School of Medicine, the Chair of Epidemiology of the TUM Department of Sport and Health Sciences, the London School of Hygiene and Tropical Medicine, the University of Edinburgh, the University of Glasgow, the International Agency for Research on Cancer (IARC) and the World Health Organization (WHO). The project received funding from the WHO using financing from the United States Agency for International Development (USAID) and the U.S. President's Emergency Plan for AIDS Relief (PEPFAR).

Publication:

Dominik Stelzle, Luana F. Tanaka, Kuan Ken Lee, Ahmadaye Ibrahim Khalil, Iacopo Baussano, Anoop S. V. Shah, David A. McAllister, Sami L. Gottlieb, Stefanie J. Klug, Andrea S. Winkler, Freddie Bray, Rachel Baggaley, Gary M. Clifford, Nathalie Broutet, Shona Dalal
Estimates of the global burden of cervical cancer associated with HIV
The Lancet Global Health, 16.11.2020 - DOI: 10.1016/S2214-109X(20)30509-X

Technical University of Munich (TUM)

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.