A research team at the Technical University of Munich (TUM) has measured the effects of infection with the Human Immunodeficiency Virus (HIV) on the development of breast cancer. Their findings show that the risk of developing breast cancer is six times higher in HIV-infected women. The south and east of Africa are particularly influential.
According to WHO statistics, breast cancer is the fourth most common type of cancer for women. In 2018 approximately 570,000 women worldwide were diagnosed with cervical carcinoma, with approximately 311,000 of those women dying.
Breast cancer, on the other hand, usually caused by Human Papillomavirus (HPV), is also one of the types of cancers that can be prevented and treated, as long as it is detected at an early stage and treated effectively. .
Simultaneous breast cancer is the most common cancer found for women living with HIV, because their immune systems are weakened by the HIV infection.
The TUM Center for Global Health at the School of Medicine and Chair of Epidemiology at TUM’s Department of Sport and Health Sciences have now dedicated their efforts to this relevant topic in the publication “Estimates of the Global Burden of Cervical Cancer Associated with HIV”, on published in the famous journal Lancet Global Health.
Systematic review and meta-analysis of 24 studies
The lead authors of Drs. Dominik Stelzle (Center for Global Health and Chair of Epidemiology) and Dr. Luana Tanaka (Chair of Epidemiology) a systematic review as well as a meta-analysis of a total of 24 studies from the years 1981 to 2016, in the 236,127 women with HIV from four continents (Africa, North America, Asia and Europe) participated.
These studies covered a total of 2,138 cases of cervical carcinoma. The results were linked to data from UNAIDS on HIV infection worldwide and with data on cervical carcinoma from the International Agency for Research on Cancer (IARC), WHO Cancer Research Center, and then evaluated.
So far there have only been estimates from countries with high net income levels. That is why we looked at the numbers on the global incidence of cervical carcinoma in relation to HIV infection and included estimates for low-income countries. In most of the world the numbers are under five percent. In some countries, however, we are talking about more than 40 percent of cases. “
Dr Dominik Stelzle, Lead study author, Center for Global Health and Chair of Epidemiology, Technical University of Munich
Women with HIV are at six times higher risk
The aim of the study was to work out the proportion of women living with HIV among the number of women with breast cancer. The authors found that 5.8 percent of new breast cancer cases worldwide in 2018 were diagnosed for women with HIV infection. This equates to 33,000 cases per year, 85 per cent of which occurred in sub-Saharan Africa.
Furthermore, based on their results the team was able to show that women with HIV have a sixfold higher risk of developing breast cancer than women without HIV infection.
“The link between cervical carcinoma and HIV is clear,” said Dr. Andrea S. Winkler, co-director of the Center for Global Health. “Cervical carcinomas are usually caused by infections with Human papillomavirus (HPV), which are sexually transmitted just like HIV. Based on our results it can be assumed that HIV infection represents a risk. for infection with HPV. “
South and east Afrika the biggest impact
The most affected regions are southern and eastern Africa, where 63.8 percent and 27.4 percent of cervical carcinomas have been diagnosed in women with HIV infection.
“With more than 75 percent, Eswatini in southern Africa is the country with the highest proportion of women suffering from cervical cancer in association with HIV infection, followed by Lesotho with 69 per cent, Botswana with 67 per cent, South Africa with 64 per cent and Zimbabwe with 52 per cent, “said Dr Tanaka.
Based on the results, the TUM authors concluded that women with HIV infection have a significantly higher risk of developing breast cancer. They also said that this means that HPV vaccinations and early cervical carcinoma screening are particularly important, especially in the southern Saharan African countries.
“While breast cancer screening already exists in Africa, so far it has been performed exclusively on women with higher socioeconomic status who were able to be screened,” says Dr. Stefanie Klug, who is Chair of Epidemiology at TU Munich. “Ending this dependence on economic means and success must include the introduction of free HPV vaccination for girls and screening for adult women. “
Source:
Munich Technical University (TUM)
Magazine Reference:
Stelzle, D., et al. (2020) Measurements of the global burden of HIV-related cervical cancer. Lancet Global Health. doi.org/10.1016/S2214-109X(20)30509-X.