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.