Trends In Cancer Screening Among People Living with HIV In Ontario, 2017 To 2023: A Population-Based Analysis

Background People living with HIV (PLWH) face a higher risk of certain cancers, making timely screening essential. This study examined cancer screening trends among individuals living with and without HIV in Ontario. Methods We conducted a retrospective longitudinal study using linked health administrative data from April 2017 to October 2023. Screening outcomes included the biannual proportion of eligible adults up to date with colorectal (fecal test in the previous two years or a flexible sigmoidoscopy or colonoscopy in the previous ten years), breast (mammogram in the previous two years), and cervical (Papanicolaou test in the previous three years) screenings. Results PLWH were more likely to live in low-income neighborhoods, urban areas, and to be immigrants, with a high burden of comorbidities. Among females, those living with HIV had consistently lower rates of up-to-date breast and colorectal cancer screenings compared to females living without HIV. In contrast, males living with HIV had higher rates of colorectal cancer screening. During the COVID-19 pandemic, screening rates dropped sharply, particularly for breast cancer screening (April 2019 vs. April 2021: declines of 12.6% for females living without HIV and 9.6% for females living with HIV). While some recovery was observed post-lockdowns, cervical screening rates remained below pre-pandemic levels. Conclusions This study reveals ongoing disparities in breast and colorectal cancer screening for females living with HIV and highlights the pandemic's impact on preventive care. Addressing barriers to cancer screening is crucial to improving health outcomes for PLWH.