Epidemiology and survival outcomes of HIV-associated cervical cancer in Nigeria

Jonah Musa; Masha Kocherginsky; Francis A. Magaji; Ali J. Maryam; Joyce Asufi; Danjuma Nenrot; Kirsten Burdett; Neelima Katam; Elizabeth N. Christian; Nisha Palanisamy; Olukemi Odukoya; Olugbenga A. Silas; Fatimah Abdulkareem; Philip Akpa; Kabir Badmos; Godwin E. Imade; Alani S. Akanmu; Demirkan B. Gursel; Yinan Zheng; Brian T. Joyce; Chad J. Achenbach; Atiene S. Sagay; Rose Anorlu; Jian Jun Wei; Folasade Ogunsola; Robert L. Murphy; Lifang Hou; Melissa A. Simon

doi:10.1186/s13027-023-00550-7

Epidemiology and survival outcomes of HIV-associated cervical cancer in Nigeria

Jonah Musa^*, Masha Kocherginsky, Francis A. Magaji, Ali J. Maryam, Joyce Asufi, Danjuma Nenrot, Kirsten Burdett, Neelima Katam, Elizabeth N. Christian, Nisha Palanisamy, Olukemi Odukoya, Olugbenga A. Silas, Fatimah Abdulkareem, Philip Akpa, Kabir Badmos, Godwin E. Imade, Alani S. Akanmu, Demirkan B. Gursel, Yinan Zheng, Brian T. JoyceChad J. Achenbach, Atiene S. Sagay, Rose Anorlu, Jian Jun Wei, Folasade Ogunsola, Robert L. Murphy, Lifang Hou, Melissa A. Simon

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: Invasive cervical cancer (ICC) is an HIV-associated cancer that is preventable and precancerous stages including early ICC stages could be detected through screening offering opportunities for treatment and cure. The high incidence in women living with HIV and late presentation often at advanced stages of ICC with limited treatment facilities often result in early mortality. We sought to compare the epidemiologic characteristics and survival differences in HIV status of ICC patients in Nigeria. Methods: We conducted a cohort study at two federal academic hospital-based research sites in Jos University Teaching Hospital, and Lagos University Teaching Hospital Nigeria, between March 2018 and September 2022. We enrolled women with histologically confirmed ICC with known HIV status, and FIGO staging as part of the United States of America’s National Institutes of Health/National Cancer Institute funded project titled ‘Epigenomic Biomarkers of HIV-Associated Cancers in Nigeria’. The primary outcome was all-cause mortality with assessment of overall survival (OS) and time to death after ICC diagnosis. OS distribution was estimated using the method of Kaplan–Meier and compared between groups using the log-rank test. Results: A total of 239 women with confirmed ICC were enrolled and included in this analysis, of whom 192 (80.3%) were HIV-negative (HIV−/ICC +), and 47 (19.7%) were HIV-positive (HIV +/ICC +). The HIV +/ICC + patients were younger with median age 46 (IQR: 40–51) years compared to 57 (IQR: 45–66) among HIV−/ICC + (P < 0.001). Squamous cell carcinoma was the commonest histopathologic variant in 80.4% of ICC diagnosis, moderately differentiated tumor grade in 68.1% in both groups. HIV +/ICC + diagnosis was at FIGO advanced stages in 64.9% compared to 47.9% in HIV−/ICC +. The HIV−/ICC + women had better OS compared to HIV +/ICC + participants (p = 0.018), with 12-month OS 84.1% (95%CI 75–90%) and 67.6% (95%CI 42–84%) respectively. Conclusion: ICC is diagnosed at a relatively young age in women living with HIV, with a significantly lower overall survival probability compared to women without HIV. The trend of presentation and diagnosis at advanced stages in women living with HIV could partly explain the differences in overall survival.

Original language	English (US)
Article number	68
Journal	Infectious Agents and Cancer
Volume	18
Issue number	1
DOIs	https://doi.org/10.1186/s13027-023-00550-7
State	Published - Dec 2023

Funding

Research findings reported in this manuscript was supported by the National Cancer Institute of the National Institutes of Health under Award Number U54CA221205, and by the Fogarty International Center of the National Institutes of Health under Award Number D43TW009575. YZ and OS received NIH/FIC funding related to this project under award number R21TW12092. JM received funding from NIH/FIC Award Number K43TW011416 for career development and research-protected time for writing and review of this manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health .

Keywords

Cervical cancer
Epidemiology
HIV
Histopathology
Survival

ASJC Scopus subject areas

Epidemiology
Oncology
Infectious Diseases
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1186/s13027-023-00550-7

Cite this

Musa, J., Kocherginsky, M., Magaji, F. A., Maryam, A. J., Asufi, J., Nenrot, D., Burdett, K., Katam, N., Christian, E. N., Palanisamy, N., Odukoya, O., Silas, O. A., Abdulkareem, F., Akpa, P., Badmos, K., Imade, G. E., Akanmu, A. S., Gursel, D. B., Zheng, Y., ... Simon, M. A. (2023). Epidemiology and survival outcomes of HIV-associated cervical cancer in Nigeria. Infectious Agents and Cancer, 18(1), Article 68. https://doi.org/10.1186/s13027-023-00550-7

@article{222b6cc7b226462cb39d57e07b3ec35b,

title = "Epidemiology and survival outcomes of HIV-associated cervical cancer in Nigeria",

abstract = "Introduction: Invasive cervical cancer (ICC) is an HIV-associated cancer that is preventable and precancerous stages including early ICC stages could be detected through screening offering opportunities for treatment and cure. The high incidence in women living with HIV and late presentation often at advanced stages of ICC with limited treatment facilities often result in early mortality. We sought to compare the epidemiologic characteristics and survival differences in HIV status of ICC patients in Nigeria. Methods: We conducted a cohort study at two federal academic hospital-based research sites in Jos University Teaching Hospital, and Lagos University Teaching Hospital Nigeria, between March 2018 and September 2022. We enrolled women with histologically confirmed ICC with known HIV status, and FIGO staging as part of the United States of America{\textquoteright}s National Institutes of Health/National Cancer Institute funded project titled {\textquoteleft}Epigenomic Biomarkers of HIV-Associated Cancers in Nigeria{\textquoteright}. The primary outcome was all-cause mortality with assessment of overall survival (OS) and time to death after ICC diagnosis. OS distribution was estimated using the method of Kaplan–Meier and compared between groups using the log-rank test. Results: A total of 239 women with confirmed ICC were enrolled and included in this analysis, of whom 192 (80.3%) were HIV-negative (HIV−/ICC +), and 47 (19.7%) were HIV-positive (HIV +/ICC +). The HIV +/ICC + patients were younger with median age 46 (IQR: 40–51) years compared to 57 (IQR: 45–66) among HIV−/ICC + (P < 0.001). Squamous cell carcinoma was the commonest histopathologic variant in 80.4% of ICC diagnosis, moderately differentiated tumor grade in 68.1% in both groups. HIV +/ICC + diagnosis was at FIGO advanced stages in 64.9% compared to 47.9% in HIV−/ICC +. The HIV−/ICC + women had better OS compared to HIV +/ICC + participants (p = 0.018), with 12-month OS 84.1% (95%CI 75–90%) and 67.6% (95%CI 42–84%) respectively. Conclusion: ICC is diagnosed at a relatively young age in women living with HIV, with a significantly lower overall survival probability compared to women without HIV. The trend of presentation and diagnosis at advanced stages in women living with HIV could partly explain the differences in overall survival.",

keywords = "Cervical cancer, Epidemiology, HIV, Histopathology, Survival",

author = "Jonah Musa and Masha Kocherginsky and Magaji, {Francis A.} and Maryam, {Ali J.} and Joyce Asufi and Danjuma Nenrot and Kirsten Burdett and Neelima Katam and Christian, {Elizabeth N.} and Nisha Palanisamy and Olukemi Odukoya and Silas, {Olugbenga A.} and Fatimah Abdulkareem and Philip Akpa and Kabir Badmos and Imade, {Godwin E.} and Akanmu, {Alani S.} and Gursel, {Demirkan B.} and Yinan Zheng and Joyce, {Brian T.} and Achenbach, {Chad J.} and Sagay, {Atiene S.} and Rose Anorlu and Wei, {Jian Jun} and Folasade Ogunsola and Murphy, {Robert L.} and Lifang Hou and Simon, {Melissa A.}",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = dec,

doi = "10.1186/s13027-023-00550-7",

language = "English (US)",

volume = "18",

journal = "Infectious Agents and Cancer",

issn = "1750-9378",

publisher = "BioMed Central",

number = "1",

}

Musa, J, Kocherginsky, M, Magaji, FA, Maryam, AJ, Asufi, J, Nenrot, D, Burdett, K, Katam, N, Christian, EN, Palanisamy, N, Odukoya, O, Silas, OA, Abdulkareem, F, Akpa, P, Badmos, K, Imade, GE, Akanmu, AS, Gursel, DB , Zheng, Y , Joyce, BT , Achenbach, CJ, Sagay, AS, Anorlu, R, Wei, JJ, Ogunsola, F, Murphy, RL , Hou, L & Simon, MA 2023, 'Epidemiology and survival outcomes of HIV-associated cervical cancer in Nigeria', Infectious Agents and Cancer, vol. 18, no. 1, 68. https://doi.org/10.1186/s13027-023-00550-7

TY - JOUR

T1 - Epidemiology and survival outcomes of HIV-associated cervical cancer in Nigeria

AU - Musa, Jonah

AU - Kocherginsky, Masha

AU - Magaji, Francis A.

AU - Maryam, Ali J.

AU - Asufi, Joyce

AU - Nenrot, Danjuma

AU - Burdett, Kirsten

AU - Katam, Neelima

AU - Christian, Elizabeth N.

AU - Palanisamy, Nisha

AU - Odukoya, Olukemi

AU - Silas, Olugbenga A.

AU - Abdulkareem, Fatimah

AU - Akpa, Philip

AU - Badmos, Kabir

AU - Imade, Godwin E.

AU - Akanmu, Alani S.

AU - Gursel, Demirkan B.

AU - Zheng, Yinan

AU - Joyce, Brian T.

AU - Achenbach, Chad J.

AU - Sagay, Atiene S.

AU - Anorlu, Rose

AU - Wei, Jian Jun

AU - Ogunsola, Folasade

AU - Murphy, Robert L.

AU - Hou, Lifang

AU - Simon, Melissa A.

PY - 2023/12

Y1 - 2023/12

N2 - Introduction: Invasive cervical cancer (ICC) is an HIV-associated cancer that is preventable and precancerous stages including early ICC stages could be detected through screening offering opportunities for treatment and cure. The high incidence in women living with HIV and late presentation often at advanced stages of ICC with limited treatment facilities often result in early mortality. We sought to compare the epidemiologic characteristics and survival differences in HIV status of ICC patients in Nigeria. Methods: We conducted a cohort study at two federal academic hospital-based research sites in Jos University Teaching Hospital, and Lagos University Teaching Hospital Nigeria, between March 2018 and September 2022. We enrolled women with histologically confirmed ICC with known HIV status, and FIGO staging as part of the United States of America’s National Institutes of Health/National Cancer Institute funded project titled ‘Epigenomic Biomarkers of HIV-Associated Cancers in Nigeria’. The primary outcome was all-cause mortality with assessment of overall survival (OS) and time to death after ICC diagnosis. OS distribution was estimated using the method of Kaplan–Meier and compared between groups using the log-rank test. Results: A total of 239 women with confirmed ICC were enrolled and included in this analysis, of whom 192 (80.3%) were HIV-negative (HIV−/ICC +), and 47 (19.7%) were HIV-positive (HIV +/ICC +). The HIV +/ICC + patients were younger with median age 46 (IQR: 40–51) years compared to 57 (IQR: 45–66) among HIV−/ICC + (P < 0.001). Squamous cell carcinoma was the commonest histopathologic variant in 80.4% of ICC diagnosis, moderately differentiated tumor grade in 68.1% in both groups. HIV +/ICC + diagnosis was at FIGO advanced stages in 64.9% compared to 47.9% in HIV−/ICC +. The HIV−/ICC + women had better OS compared to HIV +/ICC + participants (p = 0.018), with 12-month OS 84.1% (95%CI 75–90%) and 67.6% (95%CI 42–84%) respectively. Conclusion: ICC is diagnosed at a relatively young age in women living with HIV, with a significantly lower overall survival probability compared to women without HIV. The trend of presentation and diagnosis at advanced stages in women living with HIV could partly explain the differences in overall survival.

AB - Introduction: Invasive cervical cancer (ICC) is an HIV-associated cancer that is preventable and precancerous stages including early ICC stages could be detected through screening offering opportunities for treatment and cure. The high incidence in women living with HIV and late presentation often at advanced stages of ICC with limited treatment facilities often result in early mortality. We sought to compare the epidemiologic characteristics and survival differences in HIV status of ICC patients in Nigeria. Methods: We conducted a cohort study at two federal academic hospital-based research sites in Jos University Teaching Hospital, and Lagos University Teaching Hospital Nigeria, between March 2018 and September 2022. We enrolled women with histologically confirmed ICC with known HIV status, and FIGO staging as part of the United States of America’s National Institutes of Health/National Cancer Institute funded project titled ‘Epigenomic Biomarkers of HIV-Associated Cancers in Nigeria’. The primary outcome was all-cause mortality with assessment of overall survival (OS) and time to death after ICC diagnosis. OS distribution was estimated using the method of Kaplan–Meier and compared between groups using the log-rank test. Results: A total of 239 women with confirmed ICC were enrolled and included in this analysis, of whom 192 (80.3%) were HIV-negative (HIV−/ICC +), and 47 (19.7%) were HIV-positive (HIV +/ICC +). The HIV +/ICC + patients were younger with median age 46 (IQR: 40–51) years compared to 57 (IQR: 45–66) among HIV−/ICC + (P < 0.001). Squamous cell carcinoma was the commonest histopathologic variant in 80.4% of ICC diagnosis, moderately differentiated tumor grade in 68.1% in both groups. HIV +/ICC + diagnosis was at FIGO advanced stages in 64.9% compared to 47.9% in HIV−/ICC +. The HIV−/ICC + women had better OS compared to HIV +/ICC + participants (p = 0.018), with 12-month OS 84.1% (95%CI 75–90%) and 67.6% (95%CI 42–84%) respectively. Conclusion: ICC is diagnosed at a relatively young age in women living with HIV, with a significantly lower overall survival probability compared to women without HIV. The trend of presentation and diagnosis at advanced stages in women living with HIV could partly explain the differences in overall survival.

KW - Cervical cancer

KW - Epidemiology

KW - HIV

KW - Histopathology

KW - Survival

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U2 - 10.1186/s13027-023-00550-7

DO - 10.1186/s13027-023-00550-7

M3 - Article

C2 - 37915091

AN - SCOPUS:85175691298

SN - 1750-9378

VL - 18

JO - Infectious Agents and Cancer

JF - Infectious Agents and Cancer

IS - 1

M1 - 68

ER -

Epidemiology and survival outcomes of HIV-associated cervical cancer in Nigeria

Abstract

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UN SDGs

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