IS HIV-INFECTION A RISK FACTOR FOR ADVANCED CERVICAL-CANCER

Objectives: To compare HIV-infected and HIV-negative women with invasi ve cervical cancer with respect to predictors of advanced disease. Met hods: A retrospective analysis of 28 HIV-positive and 132 HIV-negative women with invasive cervical carcinoma was conducted and the two grou ps were compared with regard to stage of disease, demographic and beha vioral variables, and risk factors for advanced disease. Results: Over all, HIV-infected women were more likely to have advanced disease, bec ause 78% of HIV-positive women had Stage II to IV compared with 55% of HIV-negative women (odds ratio [OR] = 3.1; p = .03). Substance abuse was strongly associated with HIV infection, as were high-risk sexual v ariables. Although HIV infection was associated with a threefold incre ase in advance stage cervical cancer in a univariate analysis, only sy mptom duration and lack of a recent Papanicolaou smear were significan t predictors of advanced disease in a multiple logistic regression ana lysis. Conclusions: The major predictors of advanced cervical cancer a re similar in HIV-positive and HIV-negative women, although the reason s for these predictors may be very different. It is likely that a larg e proportion of HIV-positive patients with cervical cancer acquire HIV infection after initiation of the neoplastic process.