Cervical cancer screening among women living with HIV

Export Indicator

Proportion of women living with HIV (aged 30−49) old who report being screened for cervical cancer using any of the following methods: visual inspection with acetic acid (VIA), Pap smear or human papillomavirus (HPV) test
What it measures

Proportion of women living with HIV screened for cervical cancer

Rationale
Cervical cancer is the second most common type of cancer among women living in low- and middle-income countries, with an estimated 530 000 new cases in 2012 (84% of the new cases worldwide). In high-income countries, programmes are in place that enable women to get screened, making most precancerous lesions identifiable at stages when they can easily be treated and cured. Achieving high coverage of screening of women and treatment of precancerous lesions detected by screening can ensure a low incidence of invasive cervical cancer in high-income countries.
 
Women living with HIV are more vulnerable than HIV-negative women to being affected by cervical cancer and to developing invasive cancer. Invasive cervical cancer is an AIDS-defining condition. For this reason, screening women living with HIV is important. This can prevent up to 80% of the cases of cervical cancer in these countries.
Numerator
Number of women living with HIV 30−49 years old who report ever having had a screening test for cervical cancer using any of these methods: VIA, Pap smear and HPV test.
Denominator

All women respondents living with HIV 30−49 years old.

Calculation

Numerator/denominator

Method of measurement
  • Nationally representative population-based surveys
  • Programmatic data: If you do not have the number of women living with HIV (aged 30–49 years) who have ever been screened for cervical cancer, you also can provide the number of women who tested positive for HIV among all women (aged 30–49 years) who were screened for cervical  cancer.
Measurement frequency

Data should be collected at least every five years

Disaggregation
  • Age (30–49 years old or according to national guidelines)
  • Place of residence (urban or rural)
Strengths and weaknesses
Potential limitations include bias through self-report, including mistakenly assuming that any pelvic exam was a test for cervical cancer, and the limited validity of survey instruments.
Further information
Follow-up to the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases, WHO Sixty-Sixth World Health Assembly, WHA66.10, World Health Organization (http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_R10-en.pdf)
 
Noncommunicable Diseases Global Monitoring Framework: indicator definitions and specifications. Geneva: World Health Organization; 2014
 
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C et al. Globocan 2012. Estimated cancer incidence, mortality and prevalence worldwide in 2012. Lyon: International Agency for Research on Cancer; 2012 (IARC CancerBase No. 11; http://globocan.iarc.fr).
 
WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. Geneva: World Health Organization; 2013