By Amber Roman
Dec 14, 2023, 17:48 PM EST
Advances in Cervical Cancer Screening for Women with HIV in Tanzania: Study Supporting New Strategies
A recent study, published in Nature Medicine, has shed light on the effectiveness of various cervical cancer screening strategies for women with human immunodeficiency virus (HIV) in Tanzania. The results support the 2021 World Health Organization (WHO) guidelines and suggest that these strategies could be key to reducing cervical cancer mortality in this high-risk group.
Ultimately, cervical cancer represents a significant threat in low- and middle-income countries, with mortality rates particularly high in East Africa. Women with HIV face a six-fold increased risk of developing this type of cancer. The WHO global strategy to eliminate cervical cancer focuses on ambitious targets for 2030, including high rates of human papillomavirus (HPV) vaccination, regular screening and appropriate treatment.
The study used the Policy1-Cervix-HIV model, evaluating screening strategies such as primary visual inspection with acetic acid (VIA), cytology, and HPV detection. Detection scenarios with and without triage were analyzed, considering factors such as HPV 16/18 genotyping, colposcopy and cytology. Screening intervals of three, five, and ten years were assumed.
The results revealed that primary HPV testing every three years for women aged 25 to 50 years significantly reduced cervical cancer incidence rates by 64%. When HPV-positive women were prioritized before treatment, the reduction ranged from 57% to 62%, depending on the technology used. Primary cytology and VIA showed reductions of 55% and 51%, respectively.
The study also evaluated the effectiveness of primary HPV screening at five-year intervals, revealing a 59% reduction in incidence rates. The balance between benefits and harms was explored, highlighting that primary HPV screening every three years could lead to additional precancer treatments and preterm birth events. However, the number needed to treat was calculated at 38.7, indicating considerable efficacy.
The results not only support WHO guidelines but also provide a comprehensive view of screening strategies for women with HIV in Tanzania. Furthermore, they highlight the importance of considering the balance between benefits and harms when implementing these interventions, providing crucial information to address cervical cancer in high-risk contexts.
This research breakthrough not only has implications for Tanzania, but may also influence global strategies to combat cervical cancer in women with HIV, paving the way towards more effective and personalized interventions.
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