Incidence of types of cancer among HIV-infected persons compared with the general population in the United States, 1992-2003
Pragna Patel, Debra L Hanson, Patrick S Sullivan, Richard M Novak, Anne C Moorman, Tony C Tong, Scott D Holmberg, John T Brooks, Adult and Adolescent Spectrum of Disease Project and HIV Outpatient Study Investigators, Melanie Thompson, Erica Sinclair, David Cohen, Arthur Davidson, Cornelius Rietmeijer, Wendy Garland, Amy Wohl, Anne Morse, Linda Wotring, Eve Mokotoff, Chris Murrill, Marie Antoinette Bernard, Alejandro Amill, Maria de los Angeles Gomez, Sandra Miranda, Susan Buskin, Elizabeth Barash, Sylvia Odem, Philip Keiser, Adebowale Awosika-Olumo, Kathleen C Wood, Rose K Baker, Frank J Palella, Joan S Chmiel, Janet Cheley, Kenneth A Lichtenstein, Kenneth S Greenberg, Benjamin Young, Barbara Widick, Cheryl Stewart, Peggy Zellner, Bienvenido G Yangco, Kalliope Halkias, Douglas J Ward, Charles A Fiorentino, Linda Ording-Bauer, Rita Kelly, Jane Esteves, Ellen M Tedaldi, Ramona Christian, Faye Ruley, Joseph B Marzouk, Roger T Phelps, Mark Rachel, Robert E McCabe, Mark Rachel, Richard M Novak, Jonathan P Uy, Andrea Wendrow, Pragna Patel, Debra L Hanson, Patrick S Sullivan, Richard M Novak, Anne C Moorman, Tony C Tong, Scott D Holmberg, John T Brooks, Adult and Adolescent Spectrum of Disease Project and HIV Outpatient Study Investigators, Melanie Thompson, Erica Sinclair, David Cohen, Arthur Davidson, Cornelius Rietmeijer, Wendy Garland, Amy Wohl, Anne Morse, Linda Wotring, Eve Mokotoff, Chris Murrill, Marie Antoinette Bernard, Alejandro Amill, Maria de los Angeles Gomez, Sandra Miranda, Susan Buskin, Elizabeth Barash, Sylvia Odem, Philip Keiser, Adebowale Awosika-Olumo, Kathleen C Wood, Rose K Baker, Frank J Palella, Joan S Chmiel, Janet Cheley, Kenneth A Lichtenstein, Kenneth S Greenberg, Benjamin Young, Barbara Widick, Cheryl Stewart, Peggy Zellner, Bienvenido G Yangco, Kalliope Halkias, Douglas J Ward, Charles A Fiorentino, Linda Ording-Bauer, Rita Kelly, Jane Esteves, Ellen M Tedaldi, Ramona Christian, Faye Ruley, Joseph B Marzouk, Roger T Phelps, Mark Rachel, Robert E McCabe, Mark Rachel, Richard M Novak, Jonathan P Uy, Andrea Wendrow
Abstract
Background: Persons who are HIV-infected may be at higher risk for certain types of cancer than the general population.
Objective: To compare cancer incidence among HIV-infected persons with incidence in the general population from 1992 to 2003.
Design: Prospective observational cohort studies.
Setting: United States.
Patients: 54,780 HIV-infected persons in the Adult and Adolescent Spectrum of HIV Disease Project (47,832 patients) and the HIV Outpatient Study (6948 patients), who contributed 157,819 person-years of follow-up from 1992 to 2003, and 334,802,121 records from the Surveillance, Epidemiology, and End Results program of 13 geographically defined, population-based, central cancer registries.
Measurements: Standardized rate ratios (SRRs) to compare cancer incidence in the HIV-infected population with standardized cancer incidence in the general population.
Results: The incidence of the following types of non-AIDS-defining cancer was significantly higher in the HIV-infected population than in the general population: anal (SRR, 42.9 [95% CI, 34.1 to 53.3]), vaginal (21.0 [CI, 11.2 to 35.9]), Hodgkin lymphoma (14.7 [CI, 11.6 to 18.2]), liver (7.7 [CI, 5.7 to 10.1]), lung (3.3 [CI, 2.8 to 3.9]), melanoma (2.6 [CI, 1.9 to 3.6]), oropharyngeal (2.6 [CI, 1.9 to 3.4]), leukemia (2.5 [CI, 1.6 to 3.8]), colorectal (2.3 [CI, 1.8 to 2.9]), and renal (1.8 [CI, 1.1 to 2.7]). The incidence of prostate cancer was significantly lower among HIV-infected persons than the general population (SRR, 0.6 [CI, 0.4 to 0.8]). Only the relative incidence of anal cancer increased over time.
Limitations: Lower ascertainment of cancer in the HIV cohorts may result in a potential bias to underestimate rate disparities. Tobacco use as a risk factor and the effect of changes in cancer screening practices could not be evaluated.
Conclusion: The incidence of many types of non-AIDS-defining cancer was higher among HIV-infected persons than among the general population from 1992 to 2003.
Source: PubMed