CA (IF=509) The first systematic introduction to the prevention and control of cervical cancer in women infected with HIV (worthy of collection)

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Although iNature is highly preventable, cervical cancer is the world's fourth most common cancer and cause of death from cancer in women
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In low-income countries, cervical cancer is often the leading cause of cancer-related morbidity and mortality
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Women infected with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome have a particularly high risk of cervical cancer because of impaired immune response to human papillomavirus, which is the inevitable cause of almost all cervical cancers
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Globally, about one-twentieth of cervical cancers can be attributed to HIV; in sub-Saharan Africa, about one-fifth of cervical cancers are caused by HIV
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On September 9, 2021, Philip E.
Castle of NIH, USA, and others published an online review article titled "Cervical cancer prevention and control in women living with human immunodeficiency virus" in CA: A Cancer Journal for Clinicians (IF=508.
70) , The review critically evaluated the evidence to date regarding the impact of HIV disease on cervical cancer risk, described key methodological issues, and identified key outstanding research issues, especially when they apply to ongoing global prevention And control cervical cancer
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Increasing efforts to integrate HIV care with cervical cancer prevention and control, and vice versa, can help the global effort to eliminate the public health problem of cervical cancer
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Invasive cervical cancer is one of the main causes of cancer-related morbidity and mortality in women worldwide
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It is estimated that about 600,000 women worldwide are diagnosed with cervical cancer each year, and more than 300,000 women die of cervical cancer
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Women living in low- and middle-income countries (LMIC) bear a disproportionate global burden, where it is usually the first or second leading cause of female cancer cases and deaths
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With the discovery of obligate pathogens, high-risk human papillomavirus (HPV), the clarification of key steps in its natural course, and the availability of efficient primary and secondary prevention techniques, cervical cancer is a very preventable malignancy
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In fact, in the past half century, the incidence and mortality of cervical cancer have dropped sharply in countries that have implemented routine and effective cervical cancer screening and early detection programs
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The HPV vaccine may lead to a further reduction in the morbidity and mortality of cervical cancer in the coming decades
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The World Health Organization (WHO) recently launched a global initiative to accelerate the process of eliminating cervical cancer
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Solve health problems by significantly expanding HPV vaccination coverage to 90%, screening mid-adult women to 70% coverage, and treating 90% of those in need ("90-70-90")
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In the past 4 years, the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) epidemic has emerged and persisted, becoming one of the most serious public health, development and economic challenges in the world
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In 2020, there are an estimated 37.
7 million people living with HIV (PLWH) worldwide, and 53% of PLWH are women and girls
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HIV/AIDS has a disproportionate impact on people in low- and middle-income countries, where cervical cancer is also extremely common
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More than two-thirds of PLWH live in Sub-Saharan Africa (SSA)
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Untreated HIV can cause severe damage to the immune system, increasing the risk of opportunistic infections, infection-related cancers and other chronic comorbidities
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Since the mid-1990s, the availability of combined antiretroviral therapy (ART) for HIV has significantly improved the management of HIV disease, including partial or nearly complete restoration of immunity, long-term adherence to the ART regimen and retention in the HIV care continuum
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Over the past 20 years, generous bilateral and multilateral public sector and charitable initiatives have led to a significant increase in the life span of PLWH, and the incidence of HIV-related opportunistic infections, cancer and comorbidities has also been significantly improved
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For a long time, women infected with HIV (WLWH) have been considered to have a higher risk of infection, persistence and development of high-risk HPV and its downstream consequences (including cervical cancer)
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However, just like the incidence of cervical cancer among women in the general population around the world, the incidence of WLWH varies greatly among countries
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Although the incidence of cervical cancer in WLWH is higher than in women who are not infected with HIV (HIV-negative women) in any given environment/geographical area, recent meta-analysis shows that the attributable proportion of cervical cancer caused by HIV is less Much higher
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The review critically evaluated the evidence so far regarding the impact of HIV disease on cervical cancer risk, described key methodological issues, and identified key outstanding research issues, especially when they apply to ongoing global prevention and Control cervical cancer
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Increasing efforts to integrate HIV care with cervical cancer prevention and control, and vice versa, can help the global effort to eliminate the public health problem of cervical cancer
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In short, a large number of cervical cancer and related deaths (and other cancers and related deaths) can be avoided only through better and more comprehensive HIV care
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The morbidity and mortality of cervical cancer will be further reduced through primary, secondary and tertiary cervical cancer prevention services; all these services may be more effective due to better HIV care
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