Early Detection of Cancer and Precancerous Lesions in Persons With HIV Through a Comprehensive Cancer Screening Protocol
Gutiérrez, Félix (Hospital General Universitario de Elche)
López, Leandro (Hospital General Universitario de Elche)
Galera, Carlos (Hospital Clínico Universitario Virgen de la Arrixaca (El Palmar, Múrcia))
Tiraboschi, Juan Manuel (Hospital Universitari de Bellvitge)
Portu, Joseba (Arabako Unibertsitate Ospitalea (Vitoria, País Basc))
García-Fraile Fraile, Lucio (Hospital Universitario de la Princesa (Madrid))
García del Toro, Miguel (Universitat de València)
Bernal, Enrique (Hospital General Universitario Reina Sofía (Múrcia, Múrcia))
Rivero Román, Antonio (Hospital Universitario Reina Sofía (Còrdova, Espanya))
García-Abellán, Javier (Hospital General Universitario de Elche)
Flores, Juan (Hospital Arnau de Vilanova (València))
González-Cordón, Ana (Hospital Clínic i Provincial de Barcelona)
Martínez, Onofre (Hospital General Universitario Santa Lucía (Cartagena, Múrcia))
Bravo Urbieta, Joaquín (Hospital General Universitario Morales Meseguer (Múrcia))
Rosado, Dácil (Hospital Universitario de Canarias (La Laguna))
Montero, Marta (Hospital Universitari i Politècnic La Fe (València))
Sirera, Guillem (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Torralba, Miguel (Hospital Universitario de Guadalajara)
Galindo, María José (Hospital Clínic Universitari (València))
Macías, Juan (Hospital Universitario Virgen de Valme (Sevilla, Andalusia))
Gónzalez Cuello, Inmaculada (Hospital Vega Baja (Oriola, Alacant))
Boix, Vicente (Hospital General Universitario de Alicante (Alacant, País Valencià))
Vivancos, María Jesús (Hospital Universitario Ramón y Cajal (Madrid))
Dios Diez, Paula (Hospital Universitario de León)
Blanco, José Ramón (Hospital San Pedro (Logroño, La Rioja))
Padilla, Sergio (Hospital General Universitario de Elche)
Fernández-González, Marta (Hospital General Universitario de Elche)
Gutiérrez Ortiz de la Tabla, Ana (Hospital General Universitario Gregorio Marañón)
Martínez, Esteban (Hospital Clínic i Provincial de Barcelona)
Masiá, Mar (Hospital General Universitario de Elche)

Date:	2025
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.
Grants:	Instituto de Salud Carlos III PI18/01861 Instituto de Salud Carlos III CB21/13/00011
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	HIV ; Cancer ; Screening ; Surveillance ; Early diagnosis
Published in:	Clinical infectious diseases (University of Chicago. Press), Vol. 80, Núm. 2 (February 2025) , p. 371-380, ISSN 1537-6591

DOI: 10.1093/cid/ciae359
PMID: 38959300

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles