海报库PosterKeep
LBPO.PS01 · 人群科学 · Late-Breaking

2001-2019年美国HIV感染女性子宫切除校正后的宫颈癌发病率

Hysterectomy-corrected incidence of cervical cancer among women with HIV in the United States, 2001-2019

海报缩略图：2001-2019年美国HIV感染女性子宫切除校正后的宫颈癌发病率
编号 LB380 展板 10 时间 4/21 02:00–05:00 区域 Section 55 主讲 Adino Tsegaye, MPH;PhD
分会场 Late-Breaking Research: Population Sciences
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作者与单位 Authors & Affiliations

Adino T. Tsegaye1, Aimée R. Kreimer1, Jaimie Z. Shing1, Megan A. Clarke1, Tabassum Insaf2, Jennifer H. Hayes3, Qianlai Luo1, Jennifer McGee-Avila1, Ena Omoike4, Ana Patricia Ortiz5, Karen Pawlish6, Nicolas Wentzensen1, Eric A. Engels1, Meredith S. Shiels1

1National Cancer Institute, Bethesda, MD,2Bureau of Cancer Epidemiology, New York State Cancer Registry, New York, NY,3Maryland Department of Health, Prevention & Health Promotion Administration, Maryland Cancer Registry, Baltimore, MD,4Division of HIV, STD, and TB Services New Jersey Department of Health, Trenton, NJ,5Division of Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR,6New Jersey Department of Health, New Jersey State Cancer Registry, Trenton, NJ

摘要 Abstract

中文摘要
背景：将已行子宫切除的女性纳入宫颈癌发病率可能夸大发病率并误导预防项目。我们估计了HIV感染女性子宫切除校正后的宫颈癌发病率（IR），包括总体以及按组织学、年龄、种族和民族分层。 方法：我们使用来自HIV/AIDS癌症匹配研究的数据——这是美国14个HIV和癌症登记处的链接。我们计算了宫颈癌的年龄标准化发病率（ASIR），并比较了校正与未校正IR在年龄、种族/民族和组织学各组之间的绝对差异和相对差异。使用行为风险因素监测系统的数据校正子宫切除。使用泊松回归模型估计子宫切除校正和未校正的发病率比（IRR），将2005-2009、2010-2014和2015-2019年的率与2001-2004年比较，并对种族、民族、年龄和地区进行校正。 结果：在2001-2019年期间，共有958例宫颈癌病例，随访总计2,007,406人年（未校正ASIR：47.7/100,000），子宫切除校正后随访为1,632,853人年（ASIR=58.7）。子宫切除校正后的ASIR在黑人女性中增加28%（50.3对64.4），西班牙裔女性中增加18%（52.1对61.6），白人女性中增加19%（31.6对37.6）。未校正的IR在40-49岁达到峰值，呈现急剧的峰值并在更年轻和更年长的年龄组下降，而子宫切除校正后的IR呈现相对更平缓的模式，30-39、50-59和60-84岁女性的估计值相似。与2001-2004年的ASIR相比，子宫切除校正后的ASIR在随后的日历期间较低：IRR（2005-2009）：0.80，95%CI:0.66,0.97，IRR（2010-2014）：0.75，95%CI:0.61,0.91，IRR（2015-2019）：0.79，95%CI:0.64,0.97。 结论：子宫切除校正揭示了HIV感染女性宫颈癌ASIR的严重低估。子宫切除校正与未校正估计值之间在各年龄组和种族组之间存在显著差异，在黑人和白人女性以及≥50岁女性中更为明显，这是由于子宫切除患病率随年龄累积上升所致。
查看英文原文 English abstract
Background: Including hysterectomized women in cervical cancer rates potentially inflates incidence and may misguide prevention programs. We estimated the hysterectomy-corrected incidence rate (IR) of cervical cancer among women with HIV, overall and by histology, age, race and ethnicity. Methods: We used data from the HIV/AIDS Cancer Match Study - a linkage of 14 HIV and cancer registries in the US. We calculated age-standardized IR (ASIR) of cervical cancer and compared the absolute and relative differences between corrected and uncorrected IRs across age, racial/ethnic and histology groups. Data from the Behavioral Risk Factor Surveillance System was used to correct for hysterectomy. A Poisson regression model was used to estimate hysterectomy-corrected and uncorrected incidence rate ratios (IRR) comparing rates in 2005-2009, 2010-2014, and 2015-2019 to 2001-2004, adjusted for race and ethnicity, age, and region. Results: During 2001-2019, there were 958 cervical cancer cases in 2,007,406 total person-years of follow-up (uncorrected ASIR: 47.7 per 100,000) and 1,632,853 person-years of follow-up after hysterectomy correction (ASIR=58.7). The ASIR after hysterectomy correction increased by 28% among Black women (50.3 vs 64.4), 18% among Hispanic women (52.1 vs 61.6), and 19% among White women (31.6 vs 37.6). The uncorrected IRs had a peak at ages 40-49 with a sharp peak and decline in the younger and older age groups while hysterectomy-corrected IRs had relatively flatter patterns with similar estimates for 30-39, 50-59 and 60-84-year-old women. Compared to the ASIRs in 2001-2004, the hysterectomy-corrected ASIRs were lower in subsequent calendar periods: IRR (2005-2009): 0.80, 95%CI:0.66,0.97, IRR (2010-2014): 0.75, 95%CI:0.61,0.91, and IRR (2015-2019): 0.79, 95%CI:0.64,0.97. Conclusions: Hysterectomy correction unmasked substantial underestimation of cervical cancer ASIRs among women with HIV. There was a significant difference between hysterectomy-corrected and uncorrected estimates across age and racial groups, being more pronounced among Black and White women, and women aged ≥50 years due to the cumulatively rising prevalence of hysterectomy with age.
利益披露 Disclosure
A. T. Tsegaye, None.. A. R. Kreimer, None.. J. Z. Shing, None.. M. A. Clarke, None.. T. Insaf, None.. J. H. Hayes, None.. Q. Luo, None.. J. McGee-Avila, None.. E. Omoike, None.. A. P. Ortiz, None.. K. Pawlish, None.. N. Wentzensen, None.. E. A. Engels, None.. M. S. Shiels, None.

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