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Cancer Risk in Older Persons Living With Human Immunodeficiency Virus Infection in the United States
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Cancer Risk in Older Persons Living With Human Immunodeficiency Virus Infection in the United States
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Journal Article
Cancer Risk in Older Persons Living With Human Immunodeficiency Virus Infection in the United States
2018
Overview
Cancer risk in 183542 older persons living with human immunodeficiency virus infection was evaluated using data from the HIV/AIDS Cancer Match Study. Relative risk of most cancers decreased with age, but absolute risks were higher for some cancers.
Abstract
Background
Cancer risk is increased in persons living with human immunodeficiency virus (HIV) (PLWH). Improved survival has led to an aging of PLWH. We evaluated the cancer risk in older PLWH (age ≥50 years).
Methods
We included data from the HIV/AIDS Cancer Match Study (1996-2012) and evaluated risks of Kaposi sarcoma (KS), non-Hodgkin lymphoma (NHL), Hodgkin lymphoma, and cervical, anal, lung, liver, oral cavity/pharyngeal, breast, prostate, and colon cancers in older PLWH with risk in the general population by calculating standardized incidence ratios (SIRs) and excess absolute risks (EARs). Cancer risk by time since HIV diagnosis was estimated using Poisson regression.
Results
We identified 10371 cancers among 183542 older PLWH. Risk was significantly increased for KS (SIR, 103.34), NHL (3.05), Hodgkin lymphoma (7.61), and cervical (2.02), anal (14.00), lung (1.71), liver (2.91), and oral cavity/pharyngeal (1.66) cancers, and reduced for breast (0.61), prostate (0.47), and colon (0.63) cancers. SIRs declined with age for all cancers; however, EARs increased with age for anal, lung, liver, and oral cavity/pharyngeal cancers. Cancer risk was highest for most cancers within 5 years after HIV diagnosis; risk decreased with increasing time since HIV diagnosis for KS, NHL, lung cancer, and Hodgkin lymphoma.
Conclusions
Cancer risk is elevated among older PLWH. Although SIRs decrease with age, EARs are higher for some cancers, reflecting a greater absolute excess in cancer incidence among older PLWH. High risk in the first 5 years after HIV diagnosis for some cancers highlights the need for early HIV diagnosis and rapid treatment initiation.
Publisher
Oxford University Press
Subject
Acquired immune deficiency syndrome
/ Age
/ Aged
/ Aging
/ AIDS
/ Cancer
/ Cervix
/ Colon
/ Ear
/ Female
/ HIV
/ HIV Infections - complications
/ HIV Infections - epidemiology
/ Hodgkin Disease - complications
/ Hodgkin Disease - epidemiology
/ Human immunodeficiency virus
/ Humans
/ Liver
/ Lung Neoplasms - complications
/ Lung Neoplasms - epidemiology
/ Lymphoma
/ Male
/ Pharynx
/ Prostate
/ Risk
/ Sarcoma
/ Sarcoma, Kaposi - complications
/ Sarcoma, Kaposi - epidemiology
/ Uterine Cervical Neoplasms - complications
/ Uterine Cervical Neoplasms - epidemiology
/ Viruses
