Cervical cancer in Kenya and its relation to HIV infection: a study on epidemiological interactions and treatment outcome
Background: Invasive cervical cancer (ICe) is a leading cause of cancer related death among women in developing countries. HIV infection is a risk factor for premalignant cervical lesions; however, the correlation between HIV infection and ICe remains inconclusive. Equally unknown in Kenya is the current HIV seroprevalence in patients with ICe since HIV testing amongICe patients is not routine. Treatmentof cervical cancer even in optimal conditions is associated with local failure. Reasons for failure include: large volume of disease, FIGO clinical stage, inability to deliver adequate radiation doses, treatment prolongation and age of the patient. One of the common causes of treatment prolongation is co-morbidity and acute toxicity. ill environments where HIV is prevalent, it is likely to be a significant co-morbid condition in patients with lee. The chronic and opportunistic infections associated with HIV infection may profoundly affect the outcome of radiotherapytreatment for cervical cancer. There is little or no information on the impact of HIV infection on acute morbidity and pelvic tumor control following external beam radiotherapy (EBRT)in the African setting where both conditions are prevalent. Fromthe foregoing, little is known about the interaction of ICe and HIV infection, in terms of incidence, age at presentation, severity and outcome of treatment. These observations necessitatedthe need to undertake this study. 1 Broad objective: To determine the relationship between ICC and HIV infection with particular reference to the impact of HIV infection on age at presentation, severity, proportional incidence oflCC over time and treatment outcome.