HIV感染增加了患宫颈癌的风险，然而，在撒哈拉以南非洲，比较HIV感染妇女（WLWH）和无HIV的妇女之间的宫颈癌发病率的纵向研究很少。为了弥补这一空白，我们使用医疗保险计划的报销索赔数据，从2011年1月至2020年6月，在南非比较了WLWH和无HIV妇女之间的宫颈癌前病变和癌症发病率。我们使用Royston-Parmar灵活参数生存模型，按HIV状态分层估计宫颈癌前病变和癌症发病率，作为年龄的连续函数。我们的研究总人口为518,048名妇女，根据感兴趣的终点进行了排除。为了分析宫颈癌发病率，我们包括了517,312名妇女，其中564名患有宫颈癌。与无HIV的妇女相比，WLWH患宫颈癌前病变和癌症的风险约为3倍（宫颈癌的调整危险比：2.99；95%可信区间[CI]：2.40-3.73）。在所有感兴趣的终点中，WLWH的估计发病率比无HIV的妇女更高。WLWH的宫颈癌发病率在早期年龄增加，并在49岁达到高峰（122/100,000人年；95% CI：100-147），而无HIV的妇女的发病率在56岁达到高峰（40/100,000人年；95% CI：36-45）。宫颈癌前病变率在30多岁的妇女中达到高峰。根据HIV状态对年龄特定的宫颈癌发病率进行分析对于制定南部非洲和其他存在HIV和宫颈癌双重负担地区的有针对性的宫颈癌预防政策具有重要意义。© 2023 The Authors. 由John Wiley & Sons Ltd代表国际抗癌联盟发布的《国际癌症杂志》。

HIV infection increases the risk of developing cervical cancer; however, longitudinal studies in sub-Saharan Africa comparing cervical cancer rates between women living with HIV (WLWH) and women without HIV are scarce. To address this gap, we compared cervical precancer and cancer incidence rates between WLWH and women without HIV in South Africa using reimbursement claims data from a medical insurance scheme from January 2011 to June 2020. We used Royston-Parmar flexible parametric survival models to estimate cervical precancer and cancer incidence rates as a continuous function of age, stratified by HIV status. Our study population consisted of 518 048 women, with exclusions based on the endpoint of interest. To analyse cervical cancer incidence, we included 517 312 women, of whom 564 developed cervical cancer. WLWH had an ~3-fold higher risk of developing cervical precancer and cancer than women without HIV (adjusted hazard ratio for cervical cancer: 2.99; 95% confidence interval [CI]: 2.40-3.73). For all endpoints of interest, the estimated incidence rates were higher in WLWH than women without HIV. Cervical cancer rates among WLWH increased at early ages and peaked at 49 years (122/100 000 person-years; 95% CI: 100-147), whereas, in women without HIV, incidence rates peaked at 56 years (40/100 000 person-years; 95% CI: 36-45). Cervical precancer rates peaked in women in their 30s. Analyses of age-specific cervical cancer rates by HIV status are essential to inform the design of targeted cervical cancer prevention policies in Southern Africa and other regions with a double burden of HIV and cervical cancer.© 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.