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Incidence of types of cancer among HIV-infected persons compared with the general population in the United States, 1992-2003.

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.

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  • Authors+Show Affiliations

    ,

    Centers for Disease Control and Prevention, Emory University, and Northrop Grumman Information Technology, Atlanta, Georgia 30333, USA. plp3@cdc.gov

    , , , , , , ,

    Source

    Annals of internal medicine 148:10 2008 May 20 pg 728-36

    MeSH

    Adolescent
    Adult
    Aged
    Aged, 80 and over
    Female
    HIV Infections
    Humans
    Incidence
    Male
    Middle Aged
    Neoplasms
    Observation
    Prospective Studies
    Risk Factors
    Tobacco Use Disorder
    United States

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    18490686

    Citation

    Patel, Pragna, et al. "Incidence of Types of Cancer Among HIV-infected Persons Compared With the General Population in the United States, 1992-2003." Annals of Internal Medicine, vol. 148, no. 10, 2008, pp. 728-36.
    Patel P, Hanson DL, Sullivan PS, et al. Incidence of types of cancer among HIV-infected persons compared with the general population in the United States, 1992-2003. Ann Intern Med. 2008;148(10):728-36.
    Patel, P., Hanson, D. L., Sullivan, P. S., Novak, R. M., Moorman, A. C., Tong, T. C., ... Brooks, J. T. (2008). Incidence of types of cancer among HIV-infected persons compared with the general population in the United States, 1992-2003. Annals of Internal Medicine, 148(10), pp. 728-36.
    Patel P, et al. Incidence of Types of Cancer Among HIV-infected Persons Compared With the General Population in the United States, 1992-2003. Ann Intern Med. 2008 May 20;148(10):728-36. PubMed PMID: 18490686.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Incidence of types of cancer among HIV-infected persons compared with the general population in the United States, 1992-2003. AU - Patel,Pragna, AU - Hanson,Debra L, AU - Sullivan,Patrick S, AU - Novak,Richard M, AU - Moorman,Anne C, AU - Tong,Tony C, AU - Holmberg,Scott D, AU - Brooks,John T, AU - ,, PY - 2008/5/21/pubmed PY - 2008/5/30/medline PY - 2008/5/21/entrez SP - 728 EP - 36 JF - Annals of internal medicine JO - Ann. Intern. Med. VL - 148 IS - 10 N2 - 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. SN - 1539-3704 UR - https://www.unboundmedicine.com/medline/citation/18490686/full_citation L2 - https://www.annals.org/article.aspx?volume=148&issue=10&page=728 DB - PRIME DP - Unbound Medicine ER -