AIDS-defining and non-AIDS defining cancers in the post-HAART era : a study on the capacity of low-, middle- and high-income regions to document, screen, diagnose and treat HIV-related malignancies
Document type: mthesis
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Abstract:
INTRODUCTION: Since the introduction of antiretroviral treatment (ART) in 1996, the incidence of AIDS-defining cancers (ADCs), such as Kaposi sarcoma (KS) and non-Hodgkin lymphoma (NHL), has decreased in high-income countries. However, non-AIDS-defining cancers (NADCs), such as anal cancer and Hodgkin lymphoma, are on the rise. In resource-limited settings where access to ART is limited, the incidence of KS and NHL remains high, particularly in sub-Saharan Africa. There is some increasing, albeit scanty, epidemiological evidence of NADCs in low- and middle-income countries. However, there is a dire lack of information in resource-limited settings on the present capabilities for the documentation, screening, diagnosis and treatment of ADCs and NADCs. OBJECTIVE: This study aims to increase knowledge of cancer care capacities in six regions of the world as well as to identify differences between resource-rich and resource-limited settings in order to make recommendations regarding cancer care in a period of HAART scale up. METHODS: 95 IeDEA-participating HIV/AIDS health care facilities in 6 regions of the world responded to a standardized, multi-question survey on cancer care in HIV-infected patients. These data were merged and analyzed to produce preliminary statistics. FINDINGS: Even though ART access and scale up has occurred almost a decade later in Africa compared to middle- and high-income countries, a large proportion of sites from Africa ( 45%, (95% CI: 76-98%) - 62% (95% CI:80-94)) have reported NADCs among their HIV-infected cancer patients. RECOMMENDATIONS: National HIV surveillance and cancer registries should be established in order to improve the validity of epidemiologic studies in low- and middle-income countries, particularly regarding emerging NADCs. Cost-effective ways to increase capacity for the prevention and care of HIV-related malignancies should be implemented.
Authors:
Yi-Fin Tsai, J.
Category:
Research
Department:
Development Policy & Practice
Institute:
KIT (Royal Tropical Institute)
Keywords:
HIV and AIDS
,
disease prevention and control
,
health services
Language:
eng
Organization:
KIT - Royal Tropical Institute
PAGE:
53
Year:
2010
Right:
© 2010 Yi-Fin Tsai
Subject:
Health and Nutrition
Title:
AIDS-defining and non-AIDS defining cancers in the post-HAART era : a study on the capacity of low-, middle- and high-income regions to document, screen, diagnose and treat HIV-related malignancies
Training:
Master in International Health (MIH)