感染艾滋病毒的高危妇女肛门癌筛查的随访时间

IF 1.6 4区医学 Q3 ONCOLOGY

Oncology Research and Treatment Pub Date : 2025-05-31 DOI:10.1159/000546717

Steven P Masiano, Tiffany L Green, Bassam Dahman, April D Kimmel

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引用次数: 0

摘要

简介：筛查肛门癌有助于其二级预防。我们研究了高危女性艾滋病毒携带者（WLHIV）肛门癌筛查的随访时间，以及它是否随着发生肛门癌的危险因素的数量而变化。方法：一项回顾性队列研究，涉及2009年至2012年在美国16个州和哥伦比亚特区参加医疗补助计划至少两年的65岁以下高风险WLHIV患者。高风险被定义为宫颈检查结果异常或生殖器疣的病史。最初的肛门癌筛查是在高风险诊断后的第一次筛查，结果分为正常和异常。随访一直持续到下一次筛查。随访时间采用Kaplan-Meier估计量和Cox比例风险模型进行分析。结果：我们的队列包括4340名高危WLHIV患者，平均（±SD）年龄为41.8（±10.2）岁。约18%（763/4,340）同时存在这两种危险因素，而9%（374/4,340）的初次肛门癌筛查结果异常。中位时间，或50%队列接受随访筛查的时间，总体为17.53个月（95% CI = 16.13, 18.30）。与只有一种危险因素的女性相比，有两种危险因素的女性患肛门癌的随访筛查更为常见[中位时间：10.13 （95% CI = 8.90, 11.47）对19.56 （95% CI = 18.36, 21.40）个月；校正风险比(aHR) = 1.53 （95% CI = 1.38, 1.68）。在最初筛查结果异常的女性中，随访也比结果正常的女性更常见[中位时间：7.00 （95% CI = 5.40, 9.23）对18.91 （95% CI = 17.92, 20.12）个月；aHR = 2.00 （95% CI = 1.76, 2.28）。结论：高危WLHIV肛癌筛查随访时间约为1.5年，但随访时间因发生肛癌的风险而异。鉴于最近发布的肛门癌筛查指南，未来的研究应检查随访筛查时间的指南一致性。

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Follow-Up Time of Anal Cancer Screening among Women Living with HIV at High Risk of Developing Anal Cancer.

Introduction: Screening for anal cancer can help in its secondary prevention. We examined follow-up time for anal cancer screening among high-risk women living with HIV (WLHIV) and whether it varies with the number of risk factors for developing anal cancer.

Methods: A retrospective cohort study involving high-risk WLHIV under 65 enrolled in Medicaid for at least 2 years across 16 US states plus D.C. from 2009 to 2012. High risk was defined by a history of abnormal cervical test results or genital warts. Initial anal cancer screening was the first screening after a high-risk diagnosis, with results classified as normal or abnormal. Follow-up was until the next screening. Follow-up time was analyzed using the Kaplan-Meier estimator and the Cox Proportional Hazards model.

Results: Our cohort included 4,340 high-risk WLHIV, mean (±SD) age 41.8 (±10.2) years. About 18% (763/4,340) had both risk factors, while 9% (374/4,340) had abnormal results on their initial anal cancer screening. The median time, or the time at which 50% of the cohort received follow-up screening, was 17.53 (95% CI = 16.13, 18.30) months overall. Follow-up screening was more common in women with both risk factors for developing anal cancer compared to those with one risk factor (median time: 10.13 [95% CI = 8.90, 11.47] vs. 19.56 [95% CI = 18.36, 21.40] months; adjusted hazard ratio [aHR] = 1.53 [95% CI = 1.38, 1.68]). The follow-up was also more common in women with abnormal results on the initial screening compared to those with a normal result (median time: 7.00 [95% CI = 5.40, 9.23] vs. 18.91 [95% CI = 17.92, 20.12] months; aHR = 2.00 [95% CI = 1.76, 2.28]).

Conclusion: Follow-up time for anal cancer screening in high-risk WLHIV was about 1.5 years but varied according to the risk of developing anal cancer. Future research should examine the guideline-concordance of follow-up screening time given the recently issued guidelines for anal cancer screening.

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来源期刊

Oncology Research and Treatment ONCOLOGY-

CiteScore

3.20

自引率

0.00%

发文量

期刊介绍： With the first issue in 2014, the journal ''Onkologie'' has changed its title to ''Oncology Research and Treatment''. By this change, publisher and editor set the scene for the further development of this interdisciplinary journal. The English title makes it clear that the articles are published in English – a logical step for the journal, which is listed in all relevant international databases. For excellent manuscripts, a ''Fast Track'' was introduced: The review is carried out within 2 weeks; after acceptance the papers are published online within 14 days and immediately released as ''Editor’s Choice'' to provide the authors with maximum visibility of their results. Interesting case reports are published in the section ''Novel Insights from Clinical Practice'' which clearly highlights the scientific advances which the report presents.