CERVICAL-CANCER AS AN AIDS-DEFINING ILLNESS

Objective: To evaluate the importance of cervical cancer in the spectr um of human immunodeficiency virus (HIV)related diseases at a single h igh-risk institution and to compare disease characteristics in HIV-inf ected women with cervical cancer and those with other AIDS-related mal ignancies. Methods: We retrospectively reviewed data on cervical cance r and AIDS in women registered through the New York City Department of Health and institutional tumor registries from 1987 through 1995. Res ults: During the study period, cervical cancer was diagnosed in 28 HIV -positive women. In 26, cervical cancer was the initial AIDS-defining illness, representing 4% (26 of 725) of the subjects, and it was the s ixth most common initial AIDS-defining illness in women. Cervical canc er was the most common AIDS-related malignancy among women, representi ng 55% of the cases, followed by lymphoma (29%) and Kaposi sarcoma (16 %). In 71% of the women with cervical cancer, HIV infection was diagno sed at the time of cancer presentation by routine testing, whereas in women with other malignancies, HIV diagnosis preceded cancer diagnosis (70%) by a mean of 2.7 years. Patients with other malignancies had gr eater immunosuppression (mean CD4 count 153/mu L) than those with cerv ical cancer (mean CD4 count 312/mu L). The recurrence rate for women w ith cervical cancer was 88%. Although the interval from cancer diagnos is to death was similar in all three groups (9.1-12.4 months), cancer was the cause of death in 95% of HIV-infected women with cervical canc er, compared with 60% of those with other AIDS-related malignancies. C onclusion: In urban populations at increased risk for both diseases, c ervical cancer is an important AIDS-defining illness and may be the mo st common AIDS-related malignancy in women. Copyright (C) 1997 by The American College of Obstetricians and Gynecologists.