Estimates of the global burden of cervical cancer associated with HIV.

BACKGROUND: HIV enhances human papillomavirus (HPV)-induced carcinogenesis. However, the contribution of HIV to cervical cancer burden at a population level has not been quantified. We aimed to investigate cervical cancer risk among women living with HIV and to estimate the global cervical cancer burden associated with HIV. METHODS: We did a systematic literature search and meta-analysis of five databases (PubMed, Embase, Global Health [CABI.org], Web of Science, and Global Index Medicus) to identify studies analysing the association between HIV infection and cervical cancer. We estimated the pooled risk of cervical cancer among women living with HIV across four continents (Africa, Asia, Europe, and North America). The risk ratio (RR) was combined with country-specific UNAIDS estimates of HIV prevalence and GLOBOCAN 2018 estimates of cervical cancer to calculate the proportion of women living with HIV among women with cervical cancer and population attributable fractions and age-standardised incidence rates (ASIRs) of HIV-attributable cervical cancer. FINDINGS: 24 studies met our inclusion criteria, which included 236 127 women living with HIV. The pooled risk of cervical cancer was increased in women living with HIV (RR 6·07, 95% CI 4·40-8·37). Globally, 5·8% (95% CI 4·6-7·3) of new cervical cancer cases in 2018 (33 000 new cases, 95% CI 26 000-42 000) were diagnosed in women living with HIV and 4·9% (95% CI 3·6-6·4) were attributable to HIV infection (28 000 new cases, 20 000-36 000). The most affected regions were southern Africa and eastern Africa. In southern Africa, 63·8% (95% CI 58·9-68·1) of women with cervical cancer (9200 new cases, 95% CI 8500-9800) were living with HIV, as were 27·4% (23·7-31·7) of women in eastern Africa (14 000 new cases, 12 000-17 000). ASIRs of HIV-attributable cervical cancer were more than 20 per 100 000 in six countries, all in southern Africa and eastern Africa. INTERPRETATION: Women living with HIV have a significantly increased risk of cervical cancer. HPV vaccination and cervical cancer screening for women living with HIV are especially important for countries in southern Africa and eastern Africa, where a substantial HIV-attributable cervical cancer burden has added to the existing cervical cancer burden. FUNDING: WHO, US Agency for International Development, and US President's Emergency Plan for AIDS Relief

Age-specific burden of cervical cancer associated with HIV: A global analysis with a focus on sub-Saharan Africa

HIV substantially worsens human papillomavirus (HPV) carcinogenicity and contributes to an important population excess of cervical cancer, particularly in sub-Saharan Africa (SSA). We estimated HIV- and age-stratified cervical cancer burden at a country, regional, and global level in 2020. Proportions of cervical cancer a) diagnosed in women living with HIV (WLHIV), and b) attributable to HIV, were calculated using age-specific estimates of HIV prevalence (UNAIDS) and relative risk. These proportions were validated against empirical data and applied to age-specific cervical cancer incidence (GLOBOCAN 2020). HIV was most important in SSA, where 24.9% of cervical cancers were diagnosed in WLHIV, and 20.4% were attributable to HIV (vs 1.3% and 1.1%, respectively, in the rest of the world). In all world regions, contribution of HIV to cervical cancer was far higher in younger women (as seen also in empirical series). For example, in Southern Africa, where more than half of cervical cancers were diagnosed in WLHIV, the HIV-attributable fraction decreased from 86% in women ≤34 years to only 12% in women ≥55 years. The absolute burden of HIV-attributable cervical cancer (approximately 28 000 cases globally) also shifted towards younger women: in Southern Africa, 63% of 5341 HIV-attributable cervical cancer occurred in women <45 years old, compared to only 17% of 6901 non-HIV-attributable cervical cancer. Improved quantification of cervical cancer burden by age and HIV status can inform cervical cancer prevention efforts in SSA, including prediction of the impact of WLHIV-targeted vs general population approaches to cervical screening, and impact of HIV prevention

Cancer du sein au Maroc: profil phénotypique des tumeurs

Le cancer du sein est le plus fréquent chez la femme et figure parmi les principales causes de mortalité liée au cancer. La curabilité de ce type tumoral est en augmentation, grâce aux programmes de dépistage et aux progrès thérapeutiques, qui ont certes augmenté la survie des patients. Mais des défis restent à relever en rapport avec l’instabilité phénotypique des cellules cancéreuses. L’objectif de ce travail est d’étudier le profil phénotypique du cancer du sein chez les patients pris en charge au Centre Mohammed VI pour le traitement des Cancer, durant les années 2013-2014. Il s’agit d’une étude transversale sur deux années, incluant les cas du cancer du sein pris en charge au Centre. Le recueil des données était fait à partir des dossiers des patients et analysés par le logiciel Epi Info. 1277 patients ont été pris en charge au sein de notre centre. 99,5% des cas de sexe féminin, l’âge moyen était 50,20 ± 11,34 ans. Le type histologique le plus fréquent était le carcinome canalaire infiltrant (80,7% des cas). Le stade diagnostic était précoce (56,9%). Le phénotype moléculaire le plus fréquent était le luminal A (41,4% des cas). Le luminal B, le HER2 et Les triples négatifs étaient dans respectivement 10,4%, 6,3%, 11,2% des cas. L’étude du phénotype tumorale des patients atteints du cancer du sein permet l’orientation du clinicien dans le choix du traitement, et des décideurs dans la planification de programmes de lutte contre cette pathologie.The Pan African Medical Journal 2016;2

Breast Cancer in Men: Characteristics Epidemiological, Clinicopathological and Therapeutic

Abstract Background: Breast cancer is the leading malignancy in women, but it is relatively rare in men, accounting for 1% of all breast cancers. In Morocco, its incidence is 0.8/ 100,000 in men. This condition epidemiology, therapeutic and prognostic remains unknown given the scarcity of reported series. The objective of this work is to identify the epidemiological, clinical, pathological and therapeutic of this cancer in men. Results: Six patients were diagnosed with breast cancer with a ratio of 6/1277 cases. The mean age of patients was 63.3 ± 9.7 ans; the most common histological type was invasive ductal carcinoma (83.3%). The grade 2 SBR has a majority (66.7%), while that of SBR 3 is less represented (33.3%). A positive estrogen receptor (66.7% of cases) and progesterone (50.0% of cases) was noted. The HER2 receptor is overexpressed in 25% of cases. The treatment was essentially surgical (83.3%). Additional treatment included adjuvant chemotherapy (50.0%), radiotherapy (50.0%) and hormonal therapy (16.7%) was administered. Discussion/Conclusion: Breast cancer in men is rare and appears to have a very close clinical, histological characteristics and prognosis to those of elderly women. The diagnosis is usually late and tumors are treated in advanced stages. An improved prognosis requires better awareness for early detection