Cumulative incidence of cancer among persons with HIV in North America

A cohort study

North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS

Research output: Contribution to journalArticle

Abstract

Background: Cancer is increasingly common among persons with HIV. Objective: To examine calendar trends in cumulative cancer incidence and hazard rate by HIV status. Design: Cohort study. Setting: North American AIDS Cohort Collaboration on Research and Design during 1996 to 2009. Participants: 86 620 persons with HIV and 196 987 uninfected adults. Measurements: Cancer type-specific cumulative incidence by age 75 years and calendar trends in cumulative incidence and hazard rates, each by HIV status. Results: Cumulative incidences of cancer by age 75 years for persons with and without HIV, respectively, were as follows: Kaposi sarcoma, 4.4% and 0.01%; non-Hodgkin lymphoma, 4.5% and 0.7%; lung cancer, 3.4% and 2.8%; anal cancer, 1.5% and 0.05%; colorectal cancer, 1.0% and 1.5%; liver cancer, 1.1% and 0.4%; Hodgkin lymphoma, 0.9% and 0.09%; melanoma, 0.5% and 0.6%; and oral cavity/pharyngeal cancer, 0.8% and 0.8%. Among persons with HIV, calendar trends in cumulative incidence and hazard rate decreased for Kaposi sarcoma and non- Hodgkin lymphoma. For anal, colorectal, and liver cancer, increasing cumulative incidence, but not hazard rate trends, were due to the decreasing mortality rate trend (9% per year), allowing greater opportunity to be diagnosed. Despite decreasing hazard rate trends for lung cancer, Hodgkin lymphoma, and melanoma, cumulative incidence trends were not seen because of the compensating effect of the declining mortality rate. Limitation: Secular trends in screening, smoking, and viral coinfections were not evaluated. Conclusion: Cumulative cancer incidence by age 75 years, approximating lifetime risk in persons with HIV, may have clinical utility in this population. The high cumulative incidences by age 75 years for Kaposi sarcoma, non-Hodgkin lymphoma, and lung cancer support early and sustained antiretroviral therapy and smoking cessation. Primary Funding Source: National Institutes of Health.

Original languageEnglish (US)
Pages (from-to)507-518
Number of pages12
JournalAnnals of Internal Medicine
Volume163
Issue number7
DOIs
StatePublished - Oct 6 2015

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North America
Cohort Studies
HIV
Incidence
Neoplasms
Kaposi's Sarcoma
Non-Hodgkin's Lymphoma
Anus Neoplasms
Lung Neoplasms
Liver Neoplasms
Hodgkin Disease
Colorectal Neoplasms
Melanoma
Pharyngeal Neoplasms
Mortality
National Institutes of Health (U.S.)
Smoking Cessation
Coinfection
Mouth
Acquired Immunodeficiency Syndrome

ASJC Scopus subject areas

  • Internal Medicine

Cite this

North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS (2015). Cumulative incidence of cancer among persons with HIV in North America: A cohort study. Annals of Internal Medicine, 163(7), 507-518. https://doi.org/10.7326/M142768

Cumulative incidence of cancer among persons with HIV in North America : A cohort study. / North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS.

In: Annals of Internal Medicine, Vol. 163, No. 7, 06.10.2015, p. 507-518.

Research output: Contribution to journalArticle

North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS 2015, 'Cumulative incidence of cancer among persons with HIV in North America: A cohort study', Annals of Internal Medicine, vol. 163, no. 7, pp. 507-518. https://doi.org/10.7326/M142768
North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS. Cumulative incidence of cancer among persons with HIV in North America: A cohort study. Annals of Internal Medicine. 2015 Oct 6;163(7):507-518. https://doi.org/10.7326/M142768
North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS. / Cumulative incidence of cancer among persons with HIV in North America : A cohort study. In: Annals of Internal Medicine. 2015 ; Vol. 163, No. 7. pp. 507-518.
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abstract = "Background: Cancer is increasingly common among persons with HIV. Objective: To examine calendar trends in cumulative cancer incidence and hazard rate by HIV status. Design: Cohort study. Setting: North American AIDS Cohort Collaboration on Research and Design during 1996 to 2009. Participants: 86 620 persons with HIV and 196 987 uninfected adults. Measurements: Cancer type-specific cumulative incidence by age 75 years and calendar trends in cumulative incidence and hazard rates, each by HIV status. Results: Cumulative incidences of cancer by age 75 years for persons with and without HIV, respectively, were as follows: Kaposi sarcoma, 4.4{\%} and 0.01{\%}; non-Hodgkin lymphoma, 4.5{\%} and 0.7{\%}; lung cancer, 3.4{\%} and 2.8{\%}; anal cancer, 1.5{\%} and 0.05{\%}; colorectal cancer, 1.0{\%} and 1.5{\%}; liver cancer, 1.1{\%} and 0.4{\%}; Hodgkin lymphoma, 0.9{\%} and 0.09{\%}; melanoma, 0.5{\%} and 0.6{\%}; and oral cavity/pharyngeal cancer, 0.8{\%} and 0.8{\%}. Among persons with HIV, calendar trends in cumulative incidence and hazard rate decreased for Kaposi sarcoma and non- Hodgkin lymphoma. For anal, colorectal, and liver cancer, increasing cumulative incidence, but not hazard rate trends, were due to the decreasing mortality rate trend (9{\%} per year), allowing greater opportunity to be diagnosed. Despite decreasing hazard rate trends for lung cancer, Hodgkin lymphoma, and melanoma, cumulative incidence trends were not seen because of the compensating effect of the declining mortality rate. Limitation: Secular trends in screening, smoking, and viral coinfections were not evaluated. Conclusion: Cumulative cancer incidence by age 75 years, approximating lifetime risk in persons with HIV, may have clinical utility in this population. The high cumulative incidences by age 75 years for Kaposi sarcoma, non-Hodgkin lymphoma, and lung cancer support early and sustained antiretroviral therapy and smoking cessation. Primary Funding Source: National Institutes of Health.",
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AU - North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS

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AU - Lau, Bryan M

AU - Achenbach, Chad J.

AU - Jing, Yuezhou

AU - Althoff, Keri

AU - D'Souza, Gypsyamber

AU - Engels, Eric A.

AU - Hessol, Nancy A.

AU - Brooks, John T.

AU - Burchell, Ann N.

AU - Gill, M. John

AU - Goedert, James J.

AU - Hogg, Robert

AU - Horberg, Michael A.

AU - Kirk, Gregory D

AU - Kitahata, Mari M.

AU - Korthuis, Philip T.

AU - Mathews, William C.

AU - Mayor, Angel

AU - Modur, Sharada P

AU - Napravnik, Sonia

AU - Novak, Richard M.

AU - Patel, Pragna

AU - Rachlis, Anita R.

AU - Sterling, Timothy R.

AU - Willig, James H.

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N2 - Background: Cancer is increasingly common among persons with HIV. Objective: To examine calendar trends in cumulative cancer incidence and hazard rate by HIV status. Design: Cohort study. Setting: North American AIDS Cohort Collaboration on Research and Design during 1996 to 2009. Participants: 86 620 persons with HIV and 196 987 uninfected adults. Measurements: Cancer type-specific cumulative incidence by age 75 years and calendar trends in cumulative incidence and hazard rates, each by HIV status. Results: Cumulative incidences of cancer by age 75 years for persons with and without HIV, respectively, were as follows: Kaposi sarcoma, 4.4% and 0.01%; non-Hodgkin lymphoma, 4.5% and 0.7%; lung cancer, 3.4% and 2.8%; anal cancer, 1.5% and 0.05%; colorectal cancer, 1.0% and 1.5%; liver cancer, 1.1% and 0.4%; Hodgkin lymphoma, 0.9% and 0.09%; melanoma, 0.5% and 0.6%; and oral cavity/pharyngeal cancer, 0.8% and 0.8%. Among persons with HIV, calendar trends in cumulative incidence and hazard rate decreased for Kaposi sarcoma and non- Hodgkin lymphoma. For anal, colorectal, and liver cancer, increasing cumulative incidence, but not hazard rate trends, were due to the decreasing mortality rate trend (9% per year), allowing greater opportunity to be diagnosed. Despite decreasing hazard rate trends for lung cancer, Hodgkin lymphoma, and melanoma, cumulative incidence trends were not seen because of the compensating effect of the declining mortality rate. Limitation: Secular trends in screening, smoking, and viral coinfections were not evaluated. Conclusion: Cumulative cancer incidence by age 75 years, approximating lifetime risk in persons with HIV, may have clinical utility in this population. The high cumulative incidences by age 75 years for Kaposi sarcoma, non-Hodgkin lymphoma, and lung cancer support early and sustained antiretroviral therapy and smoking cessation. Primary Funding Source: National Institutes of Health.

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