PMID- 30771344
OWN - NLM
STAT- Publisher
LR  - 20190216
IS  - 1097-6868 (Electronic)
IS  - 0002-9378 (Linking)
DP  - 2019 Feb 13
TI  - Gynecologic Cancer in HIV-Positive Women: a Systematic Review and Meta-analysis.
LID - S0002-9378(19)30363-1 [pii]
LID - 10.1016/j.ajog.2019.02.022 [doi]
AB  - OBJECTIVE: While there is a significant body of literature on cervical cancer in 
      HIV-positive women, little is known about other gynecologic cancers in this
      population. The objective of this systematic review and meta-analysis is to
      describe the incidence, presentation, treatment, and outcomes for HIV-positive
      women with non-AIDS-defining gynecologic cancers. DATA SOURCE: We searched
      Medline, Embase, ClinicalTrials.gov, and the Cochrane Central Registry of
      Controlled trials for English-language studies published from 2000 to May 1,
      2017. STUDY ELIGIBILITY CRITERIA: Studies containing 1 or more HIV-positive women
      with endometrial, ovarian, or vulvovaginal cancer and reporting incidence,
      treatment regimen, or survival were included. STUDY APPRAISAL AND SYNTHESIS
      METHODS: Two authors independently reviewed abstracts and full-text articles for 
      inclusion and assessed study quality. Pooled estimates of incidence were
      calculated using random-effects models. Pooled estimates of cancer presentation
      and outcomes were averaged from case studies. RESULTS: Of 5,744 abstracts
      screened, we identified 70 articles on 58 studies on 292,202 women with HIV and
      528 women with HIV and gynecologic cancer for inclusion. Most articles (53%)
      focused on incidence, and only 3, 4, and 20 articles focused on treatment and
      outcomes of endometrial, ovarian, and vulvovaginal cancers, respectively. The
      standardized incidence ratios for endometrial, ovarian, and vulvovaginal cancers 
      were 4.38 (95%CI 0.26-8.49) for endometrial cancer, 3.21 (95%CI 2.29- 4.13) for
      ovarian cancer, and 21.93 (95%CI 13.50-30.35) for vulvovaginal cancer.
      Fifty-seven percent of women were diagnosed at an early stage, and all received
      cancer treatment. CONCLUSIONS: In women with HIV, the incidence of ovarian and
      vulvovaginal cancer were higher than the general population, while incidence of
      endometrial cancer was similar. However, there was a paucity of data on treatment
      and outcomes for non-AIDS-defining gynecologic cancers. Given the increased
      incidence of gynecologic cancer, specific research on this population is
      essential to improve treatment and outcomes for HIV-positive women.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Bodurtha Smith, Anna Jo
AU  - Bodurtha Smith AJ
AD  - Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine,
      Baltimore, MD.
FAU - Varma, Sanskriti
AU  - Varma S
AD  - Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine,
      Baltimore, MD.
FAU - Rositch, Anne F
AU  - Rositch AF
AD  - Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health,
      Johns Hopkins School of Medicine, Baltimore MD.
FAU - Levinson, Kimberly L
AU  - Levinson KL
AD  - Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine,
      Baltimore, MD; The Kelly Gynecologic Oncology Service, Department of Gynecology
      and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD. Electronic
      address: klevins1@jhmi.edu.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20190213
PL  - United States
TA  - Am J Obstet Gynecol
JT  - American journal of obstetrics and gynecology
JID - 0370476
EDAT- 2019/02/17 06:00
MHDA- 2019/02/17 06:00
CRDT- 2019/02/17 06:00
PHST- 2018/08/17 00:00 [received]
PHST- 2019/01/17 00:00 [revised]
PHST- 2019/02/07 00:00 [accepted]
PHST- 2019/02/17 06:00 [entrez]
PHST- 2019/02/17 06:00 [pubmed]
PHST- 2019/02/17 06:00 [medline]
AID - S0002-9378(19)30363-1 [pii]
AID - 10.1016/j.ajog.2019.02.022 [doi]
PST - aheadofprint
SO  - Am J Obstet Gynecol. 2019 Feb 13. pii: S0002-9378(19)30363-1. doi:
      10.1016/j.ajog.2019.02.022.