Preventive cancer screening practices in HIV-positive patients

AIDS Care. 2014 Jan;26(1):87-94. doi: 10.1080/09540121.2013.802276. Epub 2013 Jun 6.

Abstract

As patients with HIV age, they are at risk of developing non-AIDS defining malignancies. We performed a questionnaire study to evaluate colorectal and breast cancer screening among HIV-positive and HIV-negative patients seeking care from either an integrated (HIV/primary care), nonintegrated (specialized HIV), or general internal medicine clinic between August 2010 and July 2011. We performed a logistic regression to determine the odds of cancer screening. A total of 813 surveys were collected, and 762 were included in the analysis. As much as 401 were from HIV-positive patients. Patients with HIV were less likely to be current with their colorectal cancer screening (CRCS) (54.4% versus 65.0%, p=0.009); mammography rates were 24.3% versus 62.3% if done during the past year (p<0.001), and 42.0% versus 86.7% if done during the past 5 years (p<0.001). In adjusted models, the odds of colorectal cancer screening in HIV-positive patients compared to negative controls was not statistically significant (OR 0.8; 95% CI 0.5-1.3); however, HIV-positive women remained significantly less likely to be current with breast cancer screening (BCS) whether their mammogram was completed within 1 year (OR 0.1, 95% CI 0.1-0.2) or within 5 years (OR 0.1, 95% CI 0.0-0.2). Integrated care was not associated with improved screening; however, having frequent visits to a primary care physician (PCP) increased the likelihood of getting screened. BCS was lower in HIV-positive compared to HIV-negative women. Frequent visits to a PCPs improved cancer screening.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / diagnosis*
  • Colonoscopy / statistics & numerical data
  • Colorectal Neoplasms / diagnosis*
  • Cross-Sectional Studies
  • Delivery of Health Care, Integrated / statistics & numerical data*
  • Early Detection of Cancer
  • Female
  • HIV Infections / complications*
  • HIV Infections / diagnosis
  • Humans
  • Logistic Models
  • Male
  • Mammography / statistics & numerical data
  • Mass Screening / methods
  • Mass Screening / statistics & numerical data*
  • Middle Aged
  • Odds Ratio
  • Preventive Health Services / statistics & numerical data*
  • Primary Health Care
  • Socioeconomic Factors