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    Prevalence, characteristics, and outcomes of HIV-positive women diagnosed with invasive cancer of the cervix in Kenya.

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    Date
    2013
    Author
    Mungo, C
    Cohen, CR
    Maloba, M
    Bukusi, EA
    Huchko, MJ
    Type
    Article
    Language
    en
    Metadata
    Show full item record

    Abstract
    OBJECTIVE: To determine the prevalence of invasive cervical cancer (ICC) and assess access to, and outcomes of, treatment for ICC among HIV-infected women in Kisumu, Kenya. METHODS: We performed a retrospective chart review to identify women diagnosed with ICC between October 2007 and June 2012, and to examine the impact of a change in the referral protocol. Prior to June 2009, all women with ICC were referred to a regional hospital. After this date, women with stage IA1 disease were offered treatment with loop electrosurgical excision procedure (LEEP) in-clinic. RESULTS: Of 4308 women screened, 58 (1.3%) were diagnosed with ICC. The mean age at diagnosis was 34years (range, 22-50years). Fifty-four (93.1%) women had stage IA1 disease, of whom 36 (66.7%) underwent LEEP, 7 (12.9%) had a total abdominal hysterectomy, and 11 (20.4%) had unknown or no treatment. At 6, 12, and 24months after LEEP, 8.0% (2/25), 25.0% (6/24), and 41.2% (7/17) of women had a recurrence of cervical intraepithelial neoplasia 2 or worse, respectively. CONCLUSION: Most HIV-positive women diagnosed with ICC through screening had early-stage disease. The introduction of LEEP in-clinic increased access to treatment; however, recurrence was high, indicating the need for continued surveillance.
    URI
    http://www.ncbi.nlm.nih.gov/pubmed/24095308
    http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/57480
    Citation
    Int J Gynaecol Obstet. 2013 Sep 10
    Publisher
    Doris Duke Clinical Research Fellow, University of California San Francisco, San Francisco, USA
    Subject
    Cervical cancer screening
    HIV
    Kenya
    Loop Electrosurgical Excision Procedure
    Resource-limited settings
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    • Faculty of Health Sciences (FHS) [10214]

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