乳腺和妇科癌症在南非女性中的诊断比例约占所有癌症的一半，其中许多女性同时也患有HIV。我们的研究目的是确定南非HIV感染妇女（WLHIV）发展乳腺和妇科癌症的发病率和风险因素。本研究采用了南非HIV癌症匹配研究的纵向分析，包括年龄≥15岁的两个或更多次HIV相关实验室检测的妇女。我们使用Cox比例风险模型来确定人乳头状瘤病毒（HPV）相关和激素相关的妇科癌症与患者和市镇层面特征的关联。通过对3447908名妇女和1050万年的随访进行分析，我们确定了11384例新发病和7612例患有的妇科和乳腺癌症。总体的发病率为每10万人年108例（95%置信区间[CI]：106-110），其中宫颈癌的发病率最高，为每10万人年70例（95% CI：68.5-71.7）。低CD4细胞计数和高HIV RNA病毒载量增加了宫颈和其他与HPV相关的癌症的风险。年龄与HPV相关和激素相关的癌症均有关联。在高社会经济地位的市镇就医的妇女比在低社会经济地位的市镇就医的妇女更容易被诊断出HPV相关的癌症和乳腺癌。改善WLHIV的免疫状态是WLHIV癌症预防策略中的重要部分。癌症预防和早期检测计划应根据HIV感染的妇女的需求进行调整。此外，应解决癌症诊断服务中的社会经济地位不平等问题。 ©2023年该文章作者。由John Wiley & Sons Ltd代表UICC出版的《国际癌症学杂志》发布。

Breast and gynaecologic cancers account for approximately half of all cancers diagnosed amongst women in South Africa, many of whom also live with HIV. We aimed to determine the incidence of and risk factors for developing breast and gynaecologic cancers in women living with HIV (WLHIV) in South Africa. This is a longitudinal analysis of the South African HIV Cancer Match study including women aged ≥15 years with two or more HIV-related laboratory tests. We used Cox proportional hazard models to determine the association of Human Papilloma Virus (HPV)-related and hormone-related gynaecologic cancer with patient- and municipal-level characteristics. From 3 447 908 women and 10.5 million years of follow-up, we identified 11 384 incident and 7612 prevalent gynaecologic and breast cancers. The overall crude incidence rate was 108/1 00 000 person-years (pyears) (95% confidence interval [CI]: 106-110), with the highest incidence observed for cervical cancer (70/1 00 000 pyears; 95% CI: 68.5-71.7). Low CD4 cell counts and high HIV RNA viral loads increased the risk of cervical and other HPV-related cancers. Age was associated with both HPV-related and hormone-related cancers. Women accessing health facilities in high socioeconomic position (SEP) municipalities were more likely to be diagnosed with HPV-related cancers and breast cancer than women accessing care in low SEP municipalities. It is important to improve the immunologic status of WLHIV as part of cancer prevention strategies in WLHIV. Cancer prevention and early detection programmes should be tailored to the needs of women ageing with HIV. In addition, SEP disparities in cancer diagnostic services have to be addressed.© 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.