Early Detection of Cancer and Precancerous Lesions in Persons With Human Immunodeficiency Virus (HIV) Through a Comprehensive Cancer Screening Protocol
Author:
Gutiérrez Félix123ORCID, López Leandro13ORCID, Galera Carlos4, Tiraboschi Juan Manuel5ORCID, Portu Joseba6, García-Fraile Lucio37ORCID, García del Toro Miguel8, Bernal Enrique9ORCID, Rivero Antonio310ORCID, García-Abellán Javier123ORCID, Flores Juan11, González-Cordón Ana12ORCID, Martínez Onofre13, Bravo Joaquín14ORCID, Rosado Dácil15, Montero Marta16ORCID, Sirera Guillem17, Torralba Miguel18ORCID, Galindo Maria José19, Macías Juan32021ORCID, Gónzalez-Cuello Inmaculada22ORCID, Boix Vicente23ORCID, Vivancos María Jesús24, Dios Paula25ORCID, Blanco Jose Ramón26ORCID, Padilla Sergio123ORCID, Fernández-González Marta13ORCID, Gutiérrez-Ortiz de la Tabla Ana27ORCID, Martínez Esteban312, Masiá Mar123ORCID, , Gutiérrez Félix, Masiá Mar, Padilla Sergio, García-Abellán Javier, Botella Ángela, Mascarell Paula, Fernández-González Marta, García Jose Alberto, Ledesma Christian, López Leandro, Vallejo Jennifer, Robledano Catalina, Adsuar Araceli, Galera Carlos, Iglesias Helena Albendin, Navarro Antonia Castillo, Lopez Marian Fernandez, Merlos Maria Angustias, Tiraboschi Juan Manuel, Klug Ana Carina Silva, Mor Alícia Sedo, Quilen Carlos Alberto González, Piatti Camila Soledad, González Sandra Morenilla, Portu Joseba, de Adana Ester Sáez, Muñiz Irene San Jose, Arana Juan Carlos Gainzarain, García-Fraile Lucio, de los Santos Ignacio, Hernández Susana, Gutiérrez Belén, Bermúdez Ana, Casen Andoni, del Toro Miguel García, Muñoz Neus Gómez, de la Torre Marta Plaza, de Medrano Vicente Abril López, Belda José Emilio Ballester, Rodríguez Magdalena García, Salcedo Johana Isadora Gutiérrez, González José Ignacio Mateo, Olmos Carmen Ricart, Bernal Enrique, Cano Alfredo, Muñoz Ángeles, Alcaraz Antonia, Alcaraz Mª José, Villalba Mª Carmen, Rivero Antonio, Mata Díana Corona, Gallo Marina, Valero Ignacio Pérez, Flores Juan, González-Cordón Ana, Martínez Esteban, Inciarte Alexy, Martínez Onofre, García Josefina, Vera Francisco, Alcáraz Begoña, Sánchez Antonio, Martínez Lorena, Bravo Joaquín, Martínez Isabel Carpen, Garrido Rosa Mª Blazquez, Guirao Antonio Sánchez, Cascón Ana Martín, Martínez Mónica Martínez, Belando Sergio Alemán, Rosado Dácil, García Nereyda Tosco, Hernández María Jehovana, Montero Marta, Pitarch Mariona Tasias, Muñoz Eva Calabuig, Lletí Miguel Salavert, Sirera Guillem, Nieto Aroa, Novas Melani, Torralba Miguel, Galindo Pepa, Gómez Sandra Pérez, Macías Juan, Rincón Pilar, Pino María Inmaculada, Llenas-García Jara, López Belén Martínez, González-Cuello Inmaculada, López María García, Boix Vicente, Rodríguez Gema García, Esquerdo Verónica Pérez, Estévez Ángela María Rubio, Vivancos María Jesús, del Campo Terrón Santos, Pons Mario, de las Heras Daniel, Dios Paula, Mostaza José Luis, Guerra José, Blanco José Ramón, Barrio María, Pérez Reyes Pascual, Nieto Mónica Romero, Wikman Philip
Affiliation:
1. Infectious Diseases Unit, Hospital General Universitario de Elche , Elche , Spain 2. Clinical Medicine Department, Universidad Miguel Hernández , San Juan de Alicante , Spain 3. CIBERINFEC , Madrid , Spain 4. HIV and STI Unit-Service of Internal Medicine, Hospital Universitario Virgen de la Arrixaca and Instituto Murciano de Investigación Biosanitaria (IMIB) , Murcia , Spain 5. Department of Infectious Diseases, Hospital Universitari de Bellvitge, L´Hospitalet de Llobregat , Spain 6. Hospital Universitario de Araba Infectious Diseases Unit, , Vitoria-Gasteiz , Spain 7. Infectious Diseases, Hospital Universitario de La Princesa , Madrid , Spain 8. Hospital General Universitario and Universidad de Valencia Consorcio , Valencia , Spain 9. Department of Infectious Diseases, Hospital General Universitario Reina Sofía , Murcia , Spain 10. Department of Infectious Diseases, Hospital Universitario Reina Sofía and Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) , Córdoba , Spain 11. Hospital General Universitario Arnau de Vilanova Infectious Diseases Unit, , Valencia , Spain 12. Infectious Diseases Unit, Hospital Clinic de Barcelona and IDIBAPS , Barcelona , Spain 13. Infectious Diseases Unit, Hospital General Universitario Santa Lucía , Cartagena , Spain 14. Infectious Diseases Unit, Hospital General Universitario Morales Meseguer , Murcia , Spain 15. Infectious Diseases Unit, Hospital Universitario de Canarias , Canarias , Spain 16. Infectious Diseases Unit, Hospital Universitario La Fe and Instituto de Investigación La Fe , Valencia , Spain 17. Department of Infectious Diseases, Hospital Universitario Germans Trias i Pujol , Badalona , Spain 18. Service of Internal Medicine, Hospital Universitario de Guadalajara & Universidad de Alcalá, IDISCAM , Guadalajara , Spain 19. Infectious Diseases Service, Hospital Clínico de Valencia , Valencia , Spain 20. Department of Medicine, Universidad de Sevilla , Sevilla , Spain 21. Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen de Valme , Sevilla , Spain 22. Internal Medicine-Infectious Diseases, Hospital Vega Baja , Orihuela , Spain 23. Infectious Diseases Unit, Hospital Universitario de Alicante , Alicante , Spain 24. Department of Infectious Diseases, Hospital Ramón y Cajal , Madrid , Spain 25. Department of Internal Medicine, Hospital de León , León , Spain 26. Service of Infectious Diseaes, Hospital San Pedro , Logroño , Spain 27. Medical Oncology, Hospital Universitario Gregorio Marañón , Madrid , Spain
Abstract
Abstract
Background
Non-AIDS defining malignancies present a growing challenge for persons with human immunodeficiency virus (HIV, PWH), yet tailored interventions for timely cancer diagnosis are lacking. The Spanish IMPAC-Neo protocol was designed to compare two comprehensive cancer screening strategies integrated into routine HIV care. This study reports baseline data on the prevalence and types of precancerous lesions and early-stage cancer among participants at enrolment. Acceptability of the procedure was additionally assessed.
Methods
Cross-sectional analysis of a comprehensive screening protocol to detect precancer and cancer. The readiness of healthcare providers to implement the protocol was evaluated using a validated 4-item survey.
Results
Among the 1430 enrolled PWH, 1172 underwent 3181 screening tests, with positive findings in 29.4% of cases, leading to further investigation in 20.7%. Adherence to the protocol was 84%, with HIV providers expressing high acceptability (97.1%), appropriateness (91.4%), and feasibility (77.1%). A total of 145 lesions were identified in 109 participants, including 60 precancerous lesions in 35 patients (3.0%), 9 early-stage cancers in 9 patients (0.8%), and 76 low-risk lesions in 65 subjects (5.5%). Adverse events related to screening occurred in 0.8% of participants, all mild. The overall prevalence of cancer precursors or early-stage cancer was 3.8% (95% confidence interval [CI], 2.74%–5.01%), with highest rates observed in individuals screened for anal and colorectal cancers.
Conclusions
The baseline comprehensive cancer screening protocol of the IMPAC-Neo study successfully identified a significant proportion of PWH with precancerous lesions and early-stage cancer. High adherence rates and positive feedback from providers suggest effective implementation potential in real-world healthcare settings.
Funder
Spanish National Plan for Scientific and Technical Research and Innovation Instituto de Salud Carlos III Subdireccion General de Evaluacion y Fondo Europeo de Desarrollo Regional
Publisher
Oxford University Press (OUP)
|
|