Patient care and staff well-being in oncology during the coronavirus pandemic – ethical considerations
We know that the incidence of both cervical dysplasia and neoplasia is significantly increased in HIV-infected women, and the prognosis is worse compared with HIV-uninfected women (Dryden-Peterson S, Bvochora-Nsingo M, Suneja G, Efstathiou JA et al. HIV Infection and Survival Among Women With Cervical Cancer. J Clin Oncol. 2016 Nov 1; 34(31): 3749–3757).
With the introduction of antiretroviral therapy (ART) locally, and the resultant improved overall survival, HIV-infected women are now living longer. Unlike the positive effect of ART on the incidence of NHL and KS, the impact on cervical cancer has been marginal to date. This burden of HIV related cervical cancer in sub-Saharan Africa (SSA) and in our own country is of concern.
This review article by Ghebre et al. looks at this topic in detail. In particular, issues around the impact of HPV vaccination as a preventative measure, as well as screening and possible treatment pathways that could be useful in resource-limited countries are addressed. The advancements in cervical cancer control in HIV-positive women makes for both interesting, and sobering, reading.
Ghebre RG, Grover S, Xu MJ, Chuang LT, Simonds H. Cervical cancer control in HIV-infected women: Past, present and future. Gynecol Oncol Rep 2017; 21: 101–108. Published online 2017 Jul 21. doi: 10.1016/j.gore.2017.07.009)