Hysterectomy-corrected incidence of cervical cancer among women with HIV in the United States, 2001-2019

Abstract Background In the U.S., cervical cancer rates in women with HIV are notably higher than the general population. Including hysterectomized women in cervical cancer rates underestimates incidence and may misguide prevention programs. We estimated the hysterectomy-corrected incidence rates (IR) of cervical cancer among women with HIV. Methods We used data from the HIV/AIDS Cancer Match study, linking 14 HIV and cancer registries in the US. We calculated age-standardized IRs (ASIRs) of cervical cancer before and after hysterectomy correction using hysterectomy prevalence estimates from the 2001-2019 Behavioral Risk Factor Surveillance System by age, racial/ethnic and histology. We used Poisson regression to estimate IR ratios (IRR) comparing 2005-2009, 2010-2014, and 2015-2019 to 2001-2004, adjusted for race/ethnicity, age, and region. Results During 2001-2019, there were 933 cervical cancer cases in 1,966,943 person-years (uncorrected ASIR 47.4 per 100,000) and 1,597,742 person-years after correction (ASIR=58.4). Hysterectomy correction increased the ASIR by 28% among Black women (50.1 vs 64.1, p  Conclusion Without hysterectomy correction, the most pronounced underestimation of cervical cancer ASIRs among women with HIV were observed among Black women and ≥50-year-old women.