Cancer disparities in people with HIV: A systematic review of screening for non‐AIDS–defining malignancies

Corrigan, Kelsey L.; Wall, Kevin; Bartlett, John A.; Suneja, Gita

doi:10.1002/cncr.31838

Cited by 28 publications

(22 citation statements)

References 37 publications

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“…In an age without widespread use of ART, active management of other non-AIDS-defining cancers (NADCs) was less common, for the life expectancy of PLWH was relatively short [ 5 ]. As survival has improved [ 6 – 8 ], NADCs have consistently been reported, as reflected in the higher risk for cancer in PLWH compared to the general population [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Long-term outcome of renal cell carcinoma in patients with HIV who undergo surgery

Chen

Zheng

et al. 2022

BMC Infect Dis

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Background People living with HIV (PLWH) have a higher risk for cancer compared to the general population. The prevalence of renal cell carcinoma (RCC) in PLWH has gradually increased in recent years, but relevant data on outcomes after surgery are scarce. We thus evaluated long-term outcomes after surgery in RCC patients with and without HIV. Methods This retrospective study included 67 patients with RCC, both HIV positive or negative, who underwent surgical treatment in our hospital between January 2012 and January 2021. Demographic details, clinical data, and cancer status were collected. We set the day of surgery as the baseline. The co-primary end points in this time-to-event analysis were overall survival and progression-free survival. We used a multivariate Cox model to compare the prognosis of PLWH and HIV-negative patients and present Kaplan–Meier curves for the co-primary end points. Results Of 261 consecutive patients, 18 patients who forwent treatment before surgery, 133 cases with incomplete data, 16 patients classified as clinical stage IV, 11 PLWH patients did not received antiretroviral therapy and 16 patients with metastasis were excluded from the main analysis. Of the remaining 67 patients, 33 individuals had HIV and the other 34 did not. The median overall survival was 74.9 months (95% confidence interval [CI] = 64.6 to 85.2) in PLWH and 96.4 months (95% CI = 90.0 to 102.9) in the HIV-negative group. Progression-free survival was 66.4 months (95% CI = 53.5 to 79.3) and 90.6 months (95% CI = 81.1 to 100.1), respectively. RCC patients with HIV who underwent surgery had a shorter survival time (hazard ratio [HR] = 2.8, 95% CI = 1.1 to 7.0, p = 0.016) and an increased incidence of tumor progression (HR = 2.7, 95% CI = 1.1 to 6.8, p = 0.028). Univariate and multivariate Cox regression analyses showed that a lower ratio of CD4+ T cells to CD8+ T cells (adjusted odds ratio = 0.092, 95% CI = 0.01 to 0.70, p = 0.022) was associated with worse survival among PLWH. Conclusion In this retrospective analysis of RCC patients who underwent surgery, PLWH had worse overall survival and shorter progression-free survival compared to HIV-negative cases.

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Section: Introductionmentioning

confidence: 99%

Long-term outcome of renal cell carcinoma in patients with HIV who undergo surgery

Chen

Zheng

et al. 2022

BMC Infect Dis

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“…Certain cancers such as breast, cervical, and lung cancers are screened routinely as early detection improves mortality. In PLWH, these malignancies are often found at more advanced stages when compared to the general population, possibly due to a lack of adherence to screening programs [32], or possibly due to under-insurance, low income, and education within this population [33]. Cervical cancer is one of the most common ADCs, and progression of the neoplasm to a malignant state likely reflects both delayed clearance of the Human Papilloma Virus (HPV) for extended periods [34], as well as rapid progression from pre-malignant cervical carcinoma in situ (CIN) to invasive cervical cancer [35].…”

Section: Discussionmentioning

confidence: 99%

Trends of HIV-Related Cancer Mortality between 2001 and 2018: An Observational Analysis

et al. 2021

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The burden of AIDS-defining cancers has remained relatively steady for the past two decades, whilst the burden of non-AIDS-defining cancer has increased. Here, we conduct a study to describe mortality trends attributed to HIV-associated cancers in 31 countries. We extracted HIV-related cancer mortality data from 2001 to 2018 from the World Health Organization Mortality Database. We computed age-standardized death rates (ASDRs) per 100,000 population using the World Standard Population. Data were visualized using Locally Weighted Scatterplot Smoothing (LOWESS). Data for females were available for 25 countries. Overall, there has been a decrease in mortality attributed to HIV-associated cancers among most of the countries. In total, 18 out of 31 countries (58.0%) and 14 out of 25 countries (56.0%) showed decreases in male and female mortality, respectively. An increasing mortality trend was observed in many developing countries, such as Malaysia and Thailand, and some developed countries, such as the United Kingdom. Malaysia had the greatest increase in male mortality (+495.0%), and Canada had the greatest decrease (−88.5%). Thailand had the greatest increase in female mortality (+540.0%), and Germany had the greatest decrease (−86.0%). At the endpoint year, South Africa had the highest ASDRs for both males (16.8/100,000) and females (19.2/100,000). The lowest was in Japan for males (0.07/100,000) and Egypt for females (0.028/100,000).

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“…The need for screening programs is evident and not all those at risk receive this. It has been shown that access to and delivery of cancer screening are related to social determinants of health (insurance status, access to health care, education, income level) and that these barriers need to be addressed to improve cancer screening in PLWH (Corrigan, Wall, Bartlett, & Suneja, 2019).…”

Section: Question 1: What Are the Epidemiological And Clinical Featurmentioning

confidence: 99%

Viruses and oral diseases in HIV‐infected individuals on long‐term antiretroviral therapy: What are the risks and what are the mechanisms?

2020

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As a result of the extension of life span produced by increasing access to combined antiretroviral therapy, people living with HIV/AIDS (PLWH) face new challenges from comorbidities. Although advances in medical care for HIV infection have dramatically reduced opportunistic infections and AIDS‐defining cancers, some non‐AIDS‐defining cancers (NADC) and specific oral diseases such as periodontitis and salivary gland disease are now more prevalent. Cancer prevention is, therefore, a priority issue in care of PLWH, stressing both restoration of immune function and reduction of non‐HIV cancer risk factors (tobacco in all its forms; areca nut; heavy alcohol consumption; diets lacking antioxidant vitamins and minerals; and oncogenic virus infections) through specific interventions, especially tobacco and areca nut cessation and alcohol moderation. Detection of oral high‐risk human papillomaviruses (HR‐HPV) and the universal preventive HPV vaccination among PLWH should be promoted to reduce the malignancy burden, along with routine oral examinations which remain the cheapest, most reliable, most reproducible, and non‐invasive tool to identify suspicious lesions. Also, considerations of oral inflammation and periodontal health are important to replication and gene expression of viruses in the mouth. Considering that a key risk factor for this scenario is the presence of oncogenic virus infection such as several members of the human herpesvirus and human papillomavirus families, here we analyze the variables involved in the seeming increase in comorbidities in PLWH.

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Cancer disparities in people with HIV: A systematic review of screening for non‐AIDS–defining malignancies

Cited by 28 publications

References 37 publications

Long-term outcome of renal cell carcinoma in patients with HIV who undergo surgery

Long-term outcome of renal cell carcinoma in patients with HIV who undergo surgery

Trends of HIV-Related Cancer Mortality between 2001 and 2018: An Observational Analysis

Viruses and oral diseases in HIV‐infected individuals on long‐term antiretroviral therapy: What are the risks and what are the mechanisms?

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