Racial/Ethnic Disparities in the Burden of HIV/Cervical Cancer Comorbidity and Related In-hospital Mortality in the USA.
By: Hamisu Salihu, Deepa Dongarwar, Chioma A Ikedionwu, Andrea Shelton, China M Jenkins, Collins Onyenaka, Creaque Charles, Hongmei Wang, Inyang Osemene, Kiydra J Harris, Manvir Kaur, Monica Rasmus, Ololade Awosemo, Shirlette Milton, Sonnice Estill, Tolulope Adebusuyi, Xiuqing Gao, Ya Fatou N Mbye, Yuan Chen, Omonike A Olaleye

Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, TX, USA.
2020-02-19; doi: 10.1007/s40615-020-00751-5
Abstract

Objective

The purpose of this study was to determine whether cervical cancer is a risk factor for early mortality among women with HIV and whether racial/ethnic disparity predicted in-hospital death among women living with HIV and diagnosed with cervical cancer.

Methods

We conducted a population-based study using the National Inpatient Sample (NIS) database comprising hospitalized HIV-positive women with or without cervical cancer diagnosis, from 2003 through 2015. We compared trends in the rates of cervical cancer, in-hospital death, and years of potential life lost (YPLL) by race/ethnicity.

Results

We identified 2,613,696 women with HIV, and among them, 5398 had cervical cancer. The prevalence of cervical cancer (per 10,000) was 9.3 for NH-Whites, 30.9 among NH-Blacks, and 30.2 for Hispanics. Rates of cervical cancer over time diminished significantly only among NH-Whites (average annual percent change (AAPC), - 5.8 (- 9.7, - 1.8)), and YPLL in women with cervical cancer decreased significantly only in NH-Whites (AAPC, - 6.2 (- 10.1, - 2.0)). Cervical cancer was associated with increased odds of in-hospital death overall (OR 2.24 (1.59-3.15)) and among NH-Blacks (OR 2.03 (1.30-3.18)) only.

Conclusions

NH-Blacks and Hispanics with HIV remain at increased risk for concurrent diagnosis of cervical cancer compared with NH-Whites. Moreover, NH-Black women with HIV and cervical cancer are at greatest risk for in-hospital death. The findings emphasize the need for a more robust prevention strategy among minority women to reduce the high burden of HIV/cervical cancer and related mortality.





PMID:32378158






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