Author ORCID Identifier
https://orcid.org/0000-0003-0756-4733
N/A
https://orcid.org/0000-0001-9906-6234
https://orcid.org/0000-0002-3371-4582
https://orcid.org/0000-0001-8680-4015
N/A
N/A
https://orcid.org/0000-0002-5820-4829
N/A
https://orcid.org/0000-0002-7261-260X
https://orcid.org/0000-0002-0001-5152
Document Type
Article
Publication Date
2014
College/Unit
School of Medicine
Department/Program/Center
Medicine
Abstract
Background
Sub-Saharan Africa cancer registries are beset by an increasing cancer burden further exacerbated by the AIDS epidemic where there are limited capabilities for cancer-AIDS match co-registration. We undertook a pilot study based on a “strength-of-evidence” approach using clinical data that is abstracted at the time of cancer registration for purposes of linking cancer diagnosis to AIDS diagnosis.
Methods/Findings
The standard Nairobi Cancer Registry form was modified for registrars to abstract the following clinical data from medical records regarding HIV infection/AIDS in a hierarchal approach at time of cancer registration from highest-to-lowest strength-of-evidence: 1) documentation of positive HIV serology; 2) antiretroviral drug prescription; 3) CD4+ lymphocyte count; and 4) WHO HIV clinical stage or immune suppression syndrome (ISS), which is Kenyan terminology for AIDS. Between August 1 and October 31, 2011 a total of 1,200 cancer cases were registered. Of these, 171 cases (14.3%) met clinical strength-of-evidence criteria for association with HIV infection/AIDS; 69% (118 cases were tumor types with known HIV association – Kaposi’s sarcoma, cervical cancer, non-Hodgkin’s and Hodgkin’s lymphoma, and conjunctiva carcinoma) and 31% (53) were consistent with non-AIDS defining cancers. Verifiable positive HIV serology was identified in 47 (27%) cases for an absolute seroprevalence rate of 4% among the cancer registered cases with an upper boundary of 14% among those meeting at least one of strength-of-evidence criteria.
Conclusions/Significance
This pilot demonstration of a hierarchal, clinical strength-of-evidence approach for cancer-AIDS registration in Kenya establishes feasibility, is readily adaptable, pragmatic, and does not require additional resources for critically under staffed cancer registries. Cancer is an emerging public health challenge, and African nations need to develop well designed population-based studies in order to better define the impact and spectrum of malignant disease in the backdrop of HIV infection.
Digital Commons Citation
Korir, Anne; Mauti, Nathan; Moats, Pamela; Gurka, Matthew J.; Mutuma, Geoffrey; Metheny, Christine; Mwamba, Peter M.; Oyiro, Peter O.; Fisher, Melanie; Ayers, Leona W.; Rochford, Rosemary; Mwanda, Walter O.; and Remick, Scot C., "Developing Clinical Strength-of-Evidence Approach to Define HIV-Associated Malignancies for Cancer Registration in Kenya" (2014). Faculty & Staff Scholarship. 2600.
https://researchrepository.wvu.edu/faculty_publications/2600
Source Citation
Korir A, Mauti N, Moats P, Gurka MJ, Mutuma G, Metheny C, et al. (2014) Developing Clinical Strength-of-Evidence Approach to Define HIV-Associated Malignancies for Cancer Registration in Kenya. PLoS ONE 9(1): e85881. https://doi.org/10.1371/journal.pone.0085881
Comments
© 2014 Korir et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.