Low incidence of invasive cervical cancer among HIV-infected US women in a prevention program

L. Stewart Massad, Eric C. Seaberg, D. Heather Watts, Nancy A. Hessol, Sandra Melnick, Pincas Bitterman, Kathryn Anastos, Sylvia Silver, Alexandra M. Levine, Howard Minkoff

Research output: Contribution to journalArticle

54 Scopus citations


Objective: To measure the incidence of invasive cervical cancer (ICC) in US women infected with HIV. Design: Multicenter prospective cohort study, conducted between October 1994, and September 2001. Setting: HIV research centers operating as six urban consortia in the Women's Interagency HIV Study. Subjects: A total of 2131 women (462 HIV seronegative, 1661 HIV seropositive, and eight seroconverters). Women with a history of hysterectomy or of cervical cancer at baseline evaluation were excluded. Intervention: Cervical cytology obtained at 6-month intervals, with a colposcopy referral threshold of atypia, followed by individualized treatment. Main outcome measure: ICC diagnoses obtained from study databases and regional cancer registries and confirmed by a gynecologic pathologist. Results: No incident ICC were observed in HIV seronegative women during 2375 woman-years of observation. During 8260 woman-years of observation, eight putative incident cases of cervical cancer were identified in HIV seropositive women, but only one was confirmed, yielding an incidence rate of 1.2/10 000 woman-years (95% confidence interval, 0.3-6.7/ 10 000 woman-years). The difference in incidence between HIV seropositive and seronegative women was not significant (P = 1.0). Conclusion: ICC is uncommon in HIV-infected US women participating in a regular prevention program.

Original languageEnglish (US)
Pages (from-to)109-113
Number of pages5
Issue number1
StatePublished - Jan 2 2004



  • Cancer incidence
  • Cancer registry
  • Cancer screening
  • Cervical cancer
  • HIV in women

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Massad, L. S., Seaberg, E. C., Watts, D. H., Hessol, N. A., Melnick, S., Bitterman, P., Anastos, K., Silver, S., Levine, A. M., & Minkoff, H. (2004). Low incidence of invasive cervical cancer among HIV-infected US women in a prevention program. AIDS, 18(1), 109-113. https://doi.org/10.1097/00002030-200401020-00013