Browsing by Author "Intimayta-Escalante, C"

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Clinicopathological Features and Mortality in Patients With Kaposi Sarcoma and HIV: A Retrospective Analysis of a Thirty-Year Study From a Peruvian Oncologic Center
(Lippincott Williams and Wilkins, 2022) Cuellar Ponce de Loen, LE; Meza, K; Holguín Ruíz, AM; Velarde Marca, J; Portillo-Alvarez, D; Castro, V; Sulca-Huamani, O; Intimayta-Escalante, C; Gaby-Pérez, R; Patel, A
PURPOSEKaposi's sarcoma (KS) is a multifocal angioproliferative disease. In Peru, the implementation of the highly active antiretroviral treatment (HAART) program was in 2005, the model for treating patients with HIV-positive KS shifted to a potential cure. In this study, we aim to compare clinicopathological characteristics and prognostic factors associated with outcomes in patients with HIV-positive KS.METHODSWe developed a retrospective cohort study that includes patients with HIV/AIDS and KS seen in the Instituto Nacional de Enfermedades Neoplasicas between 1987 and 2017. Patients were divided into two groups according to the implementation of HAART in our country: the non-HAART group and those treated with HAART after 2005. Multivariate analysis for overall survival (OS) was performed with the Cox proportional hazard regression model.RESULTSThere was a greater visceral compromise and more extensive oral cavity involvement in the non-HAART group (60% 31.7%, P <.01). Regarding the immune status, there was a significant difference from the CD4 count at 1-year follow-up (73 v 335, P =.01). The CD4/CD8 rate were significant different before QT (0.23 v 0.13, P =.01) and at 1-year follow-up (0.12 v 0.32, P =.03.). The estimated 5-year OS rate was significantly lower (P =.0001) for the non-HAART group (41.7% 95% CI, 25.9 to 56.9) compared with the HAART group (79.3% 95% CI, 66.8 to 87.5). In the multivariate model for OS, full-HAART regimen and previous diagnosis of HIV/AIDS (P <.01) were significantly associated with longer survival.CONCLUSIONClinical and demographic characteristics of our patients are compatible with the literature, but we report a higher rate of gastrointestinal involvement. Furthermore, our findings provide evidence for the importance of HAART and its ability to reduce KS-related mortality.
Ethnic inequalities in coverage and use of women’s cancer screening in Peru
(BioMed Central Ltd, 2024) Intimayta-Escalante, C
Objective: This study aimed to assess ethnic inequalities in the coverage and utilization of cancer screening services among women in Peru. Methods: Data from the 2017–2023 Demographic and Family Health Survey in Peru were analyzed to evaluate ethnic disparities in screening coverage for breast and cervical cancer, including clinical breast examination (CBE), Pap smear test (PST), and mammography. Measures such as the GINI coefficient and Slope Index of Inequality (SII) were used to quantify coverage and utilization disparities among ethnic groups. Results: The study included 70,454 women aged 30–69. Among women aged 40–69, 48.31% underwent CBE, 84.06% received PST, and 41.69% underwent mammography. It was found inequalities in coverage for any cancer screening (GINI: 0.10), mammography (GINI: 0.21), CBE (GINI: 0.19), and PST (GINI: 0.06), in 25 Peruvian regions. These inequalities were more pronounced in regions with larger populations of Quechua, Aymara, and Afro-Peruvian women. In rural areas, Quechua or Aymara women (SII: -0.83, -0.95, and − 0.69, respectively) and Afro-Peruvian women (SII: -0.80, -0.92, and − 0.58, respectively) experienced heightened inequalities in the uptake of CBE, mammography, and PST, respectively. Like Quechua or Aymara women (SII: -0.50, SII: -0.52, and SII: -0.50, respectively) and Afro-Peruvian women (SII: -0.50, SII: -0.58, and SII: -0.44, respectively) with only a primary education. Conclusion: Ethnic inequalities affect breast and cervical cancer screening coverage across regions in Peru. In Quechua, Aymara, and Afro-Peruvian women the uptake of mammography, CBE, and PST was less frequently than their white or mestizo counterparts. These inequalities are attributed to sociodemographic conditions such as lower education levels and residence in rural or non-capital areas.