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Age at Diagnosis of Preinvasive and Invasive Cervical Neoplasia in South Africa: HIV-Positive Versus HIV-Negative Women
  1. Louis-Jacques Jean van Bogaert, MD, PhD, DPhil
  1. National Health Laboratory Services and the Polokwane Campus of the University of Limpopo, Polokwane, South Africa.
  1. Address correspondence and reprint requests to Louis-Jacques Jean van Bogaert, MD, PhD, DPhil, Post Net Suite 7, Private Bag x8689, Groblersdal 0470, South Africa. E-mail: ljfvanbo{at}


Hypothesis: Human immunodeficiency virus-positive women develop invasive cervical cancer at a significantly earlier age than seronegative women. It is hypothesized that this might result from shorter preinvasive stages.

Methods: Prospective observational study of histologically diagnosed 398 low-grade (LGSIL), 738 high-grade intraepithelial lesions (HGSIL), and 1048 invasive cancers (IC) in a black South African population. The study comprised of 493 (22.6%) seropositive women and 1691 (77.4%) seronegative women who served as the controls. All were subdivided into 5-years age bands.

Results: The mean age at diagnosis of LGSIL and HGSIL was similar in the cases (t = 0.7; P = 0.49) and the controls (t = 1.2; P = 0.22). The mean age at diagnosis of IC was significantly younger in the HIV-seropositive women than in the HIV-seronegative women (t = 14.0; P < 0.0001). The relative age distribution curves of LGSIL, HGSIL, and IC evolved close to each other in the cases. In the seronegative women, there was an 18-year lag between the peak age distribution of HGSIL and IC.

Conclusion: Our data support the hypothesis of a shorter preinvasive stage in HIV-positive women.

  • Preinvasive cervical lesion
  • Invasive cervical cancer
  • HIV
  • Age at diagnosis

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  • The authors did not receive funding for this work.

  • The authors did not have conflict of interest.