Cribado de cáncer en personas con VIH: aplicación en la práctica clínica y barreras percibidas por los médicos especialistas en España

Abstract

ObjectiveTo assess the degree of implementation of cancer screening recommendations in people living with HIV (PLHIV) in Spain. MethodsA self-administered questionnaire was designed on the strategies used for early detection of the main types of cancer in PLHIV. The survey was distributed electronically to HIV physicians participating in the Spanish CoRIS cohort. ResultsOne hundred and six questionnaires were received from 12 different Spanish autonomous communities, with an overall response rate among those who accessed the questionnaire of 60.2%. The majority responded that they followed the clinical practice guidelines recommendations for the early detection of liver (94.3%), cervical (93.2%) and breast (85.8%) cancers. In colorectal and anal cancer, the proportion was 68.9% and 63.2%, and in prostate and lung cancer of 46.2% and 19.8%, respectively. In hospitals with a greater number of beds, a tendency to perform more cancer screening and greater participation of the infectious diseases/HIV services in the screening programs was observed. Significant differences were observed in the frequency of colorectal and anal cancer screening among the different autonomous communities. The most frequent reasons for not performing screening were the scarcity of material and/or human resources and not being aware of what is recommended in the clinical practice guidelines. ConclusionsThere are barriers and opportunities to expand cancer screening programs in PLHIV, especially in colorectal, anal and lung cancers. It is necessary to allocate resources for the early detection of cancer in PLHIV, but also to disseminate clinical practice guidelines screening recommendations among medical specialists.