Journal of the National Cancer Institute · 2026
Hysterectomy-corrected incidence of cervical cancer among women with HIV in the United States, 2001-2019.
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Tsegaye Adino Tesfahun, Kreimer Aimée R, Shing Jaimie Z, Clarke Megan A, Insaf Tabassum, Hayes Jennifer H, Luo Qianlai, McGee-Avila Jennifer, Omoike Ena, Ortiz Ana Patricia, Pawlish Karen, Wentzensen Nicolas, Engels Eric A, Shiels Meredith S
Аннотация
BACKGROUND: In the U.S., cervical cancer rates in women with HIV are notably higher than the general population. Including hysterectomized women in cervical cancer rates underestimates incidence and may misguide prevention programs. We estimated the hysterectomy-corrected incidence rates (IR) of cervical cancer among women with HIV.
METHODS: We used data from the HIV/AIDS Cancer Match study, linking 14 HIV and cancer registries in the US. We calculated age-standardized IRs (ASIRs) of cervical cancer before and after hysterectomy correction using hysterectomy prevalence estimates from the 2001-2019 Behavioral Risk Factor Surveillance System by age, racial/ethnic and histology. We used Poisson regression to estimate IR ratios (IRR) comparing 2005-2009, 2010-2014, and 2015-2019 to 2001-2004, adjusted for race/ethnicity, age, and region.
RESULTS: During 2001-2019, there were 933 cervical cancer cases in 1,966,943 person-years (uncorrected ASIR 47.4 per 100,000) and 1,597,742 person-years after correction (ASIR=58.4). Hysterectomy correction increased the ASIR by 28% among Black women (50.1 vs 64.1, p < 0.0001), 18% among Hispanic women (51.7 vs 61.2, p = 0.07), and 20% among White women (30.8 vs 36.9, p = 0.26). Uncorrected ASIRs peaked at ages 40-49 and declined at older ages, while hysterectomy-corrected ASIRs remained highest at ages 40-49 but declined less with age, with similar rates among women aged 50-59 and 60-84. Compared with 2001-2004, corrected ASIRs were lower in 2005-2009 (IRR=0.79, 95%CI: 0.65,0.96); 2010-2014 (IRR=0.75, 95%CI: 0.61,0.91); and 2015-2019 (IRR=0.78, 95%CI: 0.63,0.97).
CONCLUSION: Without hysterectomy correction, the most pronounced underestimation of cervical cancer ASIRs among women with HIV were observed among Black women and ≥50-year-old women.
METHODS: We used data from the HIV/AIDS Cancer Match study, linking 14 HIV and cancer registries in the US. We calculated age-standardized IRs (ASIRs) of cervical cancer before and after hysterectomy correction using hysterectomy prevalence estimates from the 2001-2019 Behavioral Risk Factor Surveillance System by age, racial/ethnic and histology. We used Poisson regression to estimate IR ratios (IRR) comparing 2005-2009, 2010-2014, and 2015-2019 to 2001-2004, adjusted for race/ethnicity, age, and region.
RESULTS: During 2001-2019, there were 933 cervical cancer cases in 1,966,943 person-years (uncorrected ASIR 47.4 per 100,000) and 1,597,742 person-years after correction (ASIR=58.4). Hysterectomy correction increased the ASIR by 28% among Black women (50.1 vs 64.1, p < 0.0001), 18% among Hispanic women (51.7 vs 61.2, p = 0.07), and 20% among White women (30.8 vs 36.9, p = 0.26). Uncorrected ASIRs peaked at ages 40-49 and declined at older ages, while hysterectomy-corrected ASIRs remained highest at ages 40-49 but declined less with age, with similar rates among women aged 50-59 and 60-84. Compared with 2001-2004, corrected ASIRs were lower in 2005-2009 (IRR=0.79, 95%CI: 0.65,0.96); 2010-2014 (IRR=0.75, 95%CI: 0.61,0.91); and 2015-2019 (IRR=0.78, 95%CI: 0.63,0.97).
CONCLUSION: Without hysterectomy correction, the most pronounced underestimation of cervical cancer ASIRs among women with HIV were observed among Black women and ≥50-year-old women.