481. Lower Cancer Screening Rates among HIV vs. non-HIV Patients
Session: Poster Abstract Session: HIV Primary Care
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • Johnson HIV Screening IDSA 2011.pdf (48.9 kB)
  • Background:  The use of antiretroviral therapy has resulted in dramatic reductions in mortality and AIDS-related conditions. There has been an increase in non-AIDS related malignancies in patients with HIV, emphasizing the importance of routine cancer screening in HIV patients.   

    Methods:  To evaluate compliance with cancer screening guidelines for breast, cervical and colon cancer in HIV patients compared with general medicine patients.  We also evaluated compliance based on specialty, Infectious Diseases (ID) versus Internal Medicine (IM).  We performed a retrospective case-control (1:1) study of cancer screening among 78 HIV patients seen by ID specialists (cases) compared to age and gender matched HIV negative patients who were seen by IM specialists from 1/1- 12/31/09 at an academic practice (controls).  Patients were identified using billing information and patients were excluded for the following:  <2 visits during the study period, males <50 years, terminally ill patients and resident/fellow-covered patients. American Cancer Society guidelines for breast, cervical and colon screening were used and information was collected on whether screening was recommended and performed.  Data was analyzed using X2 and Student’s t test and statistical analysis was performed using SPSS v. 19.0. A p < 0.05 was considered significant.

    Results: Among the 156 cases and controls, the mean age was 54.1±9.4 years; 61.5% were male.   Cases were less likely to have been recommended or performed cancer screening by ID specialists compared with controls (Table). There were no statistically significant differences in the percentage of individuals with HIV who had screening ordered or done by whether or not they had a primary care provider (PCP).

     

    Cases (HIV)

    Controls

    p

    Colonoscopy ordered

    54.2%

    89.8%

    <0.0001

    Colonoscopy performed

    45.8%

    67.8%

    <0.016

    Mammogram ordered

    54.2%

    91.7%

    0.003

    Mammogram performed

    45.8%

    83.3%

    0.007

    PAP ordered

    60%

    86.7%

    0.02

    PAP performed

    60%

    80%

    0.09

    Conclusion: HIV patients were less likely to have routine cancer screening regardless of whether or not they had a PCP.  There needs to be an increased emphasis on routine cancer screening for HIV patients among physicians.


    Subject Category: H. HIV/AIDS and other retroviruses

    Dima Abdul Jabbar, MD1, Susan Szpunar, PhD1, Louis Saravolatz, MD2,3 and Leonard Johnson, MD3,4, (1)St. John Hospital and Medical Center, Grosse Pointe Woods, MI, (2)Internal Medicine, St. John Hospital and Medical Center, Grosse Pointe Woods, MI, (3)Wayne State University, Grosse Pointe Woods, MI, (4)Medicine, St. John Hospital and Medical Center, Grosse Pointe Woods, MI

    Disclosures:

    D. Abdul Jabbar, None

    S. Szpunar, None

    L. Saravolatz, Astellas: Grant Investigator and Speaker's Bureau, Research grant and Speaker honorarium
    Forest Laboratories: Grant Investigator and Speaker's Bureau, Research grant and Speaker honorarium

    L. Johnson, None

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