Wijayabahu Akemi T, Zhou Zhi, Cook Robert L, Brumback Babette, Ennis Nicole, Yaghjyan Lusine
Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, 2004 Mowry Road, PO Box 100321, Gainesville, FL, 32610-0231, USA.
Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, USA.
Cancer Causes Control. 2019 Mar;30(3):281-290. doi: 10.1007/s10552-019-1135-3. Epub 2019 Feb 9.
The prevalence of non-AIDS-related malignancies is on the rise among people aging with HIV population, but the evidence on healthy behaviors including cancer screening practices in this population subgroup is extremely limited. Therefore, we investigated the prevalence of healthy behaviors and sex-specific cancer screening among persons living with HIV, by sex and time since HIV diagnosis.
We included 517 persons living with HIV from the Florida Cohort. Data were obtained from the baseline and follow-up questionnaires, electronic medical records, and Enhanced HIV/AIDS Reporting System. The prevalence of self-reported, age-appropriate cancer screening (anal, colorectal, prostate, breast, and cervical), and healthy behaviors (sustaining healthy body weight, refraining from smoking and alcohol and engaging in physical activity) was compared by sex and years since HIV diagnosis (≤ 13 vs. > 13 years).
In the analyses by sex, females were more likely to be obese than males (56.5% vs. 22.2%, p < 0.0001). Distribution of healthy behaviors did not differ by time since diagnosis among males and females. In the analysis of age-appropriate screening among males, 64.8% never had an anal Pap-smear, 36.2% never had a colonoscopy, and 38.9% never had prostate cancer screening. In the analysis of age-appropriate screening among females, 50.0% never had an anal Pap-smear, 46.5% never had a colonoscopy, 7.9% never had a cervical Pap-smear, and 12.7% never had a mammogram. The difference in anal Pap-smear by sex was statistically significant (p < 0.0001). Among males, the age-adjusted prevalence of never having a colonoscopy was higher in those who had HIV for ≤ 13 years (50.8% vs. 30.6%, p = 0.03).
The prevalence of selected healthy behaviors and cancer screening differed by sex and/or years since HIV diagnosis suggesting a need for tailored cancer prevention efforts among persons living with HIV via long-term sex-specific interventions.
在携带HIV的老年人群中，非艾滋病相关恶性肿瘤的患病率正在上升，但关于该人群亚组中包括癌症筛查行为在内的健康行为的证据极为有限。因此，我们按性别以及自HIV诊断后的时间，调查了HIV感染者中健康行为的患病率以及特定性别的癌症筛查情况。
我们纳入了来自佛罗里达队列的517名HIV感染者。数据来自基线和随访问卷、电子病历以及强化HIV/艾滋病报告系统。通过性别以及自HIV诊断后的年份（≤13年与>13年），比较了自我报告的、适合年龄的癌症筛查（肛门、结肠、前列腺、乳腺和宫颈）以及健康行为（维持健康体重、戒烟限酒和进行体育活动）的患病率。
在按性别进行的分析中，女性比男性更易肥胖（56.5%对22.2%，p<0.0001）。男性和女性自诊断后的时间不同，健康行为的分布并无差异。在对男性适合年龄的筛查分析中，64.8%的人从未进行过肛门巴氏涂片检查，36.2%的人从未进行过结肠镜检查，38.9%的人从未进行过前列腺癌筛查。在对女性适合年龄的筛查分析中，50.0%的人从未进行过肛门巴氏涂片检查，46.5%的人从未进行过结肠镜检查，7.9%的人从未进行过宫颈巴氏涂片检查，12.7%的人从未进行过乳房X光检查。肛门巴氏涂片检查的性别差异具有统计学意义（p<0.0001）。在男性中，HIV感染时间≤13年的人群中从未进行过结肠镜检查的年龄调整患病率更高（50.8%对30.6%，p=0.03）。
特定健康行为和癌症筛查的患病率因性别和/或自HIV诊断后的年份而异，这表明需要通过长期针对性别的干预措施，对HIV感染者进行量身定制的癌症预防工作。
