Disparities in breast cancer survival between women with and without HIV across sub-Saharan Africa (ABC-DO): a prospective, cohort study

Chasimpha, Steady; McCormack, Valerie; Cubasch, Herbert; Joffe, Maureen; Zietsman, Annelle; Galukande, Moses; Parham, Groesbeck P.; Pinder, Leeya; Anele, Angelica A.; Adisa, Charles; Offiah, A.U.; Anderson, Benjamin O.; Boucheron, Patrick; Foerster, Milena; Schüz, Joachim; dos‐Santos‐Silva, Isabel

doi:10.1016/s2352-3018(21)00326-x

Cited by 16 publications

(22 citation statements)

References 31 publications

(46 reference statements)

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“…Currently, patients with HIV are diagnosed with breast cancer at younger ages compared with patients uninfected with HIV (approximately 10 years younger) 18 , 19 because patients with HIV are younger than HIV-uninfected women in the general population. However, it remains unclear whether HIV predisposes patients with HIV to early onset of breast cancer, an issue that may be setting-specific, and although initial findings do not suggest a difference, 6 , 20 - 22 further data on whether breast cancer subtypes differ by HIV are needed. Nevertheless, it is well established that younger patients with breast cancer uninfected by HIV present with more aggressive tumor subtypes, leading to poor prognosis and high recurrence rates.…”

Section: Breast Tumor Characteristicsmentioning

confidence: 99%

“…The absolute 3-year overall survival was 9% lower for patients with HIV and breast cancer (HR, 46%; 95% CI, 40 to 53) versus (HR, 55%; 95% CI, 52 to 59) for patients with breast cancer uninfected by HIV in the African Breast Cancer-Disparities in Outcomes (ABC-DO) study. 5 , 6 The ABC-DO study and South African Breast Cancer and HIV Outcomes (SABCHO) study, 7 to our knowledge, the two largest prospective cohorts of women newly diagnosed with breast cancer in SSA (n = 313 and 600 patients with HIV, respectively, with a small number contributing to both cohorts) reported age- and stage-adjusted all-cause mortality HRs in HIV-infected versus HIV-uninfected patients with breast cancer of 1.41 (95% CI, 1.15 to 1.74) 6 and 1.50 (95% CI, 1.22 to 1.85), 8 respectively.…”

Section: Introductionmentioning

confidence: 99%

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Survival Disparities Between Patients with Breast Cancer With and Without HIV: A Research Framework

Chasimpha

dos‐Santos‐Silva

Martei

et al. 2023

JCO Global Oncology

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Section: Breast Tumor Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Survival Disparities Between Patients with Breast Cancer With and Without HIV: A Research Framework

Chasimpha

dos‐Santos‐Silva

Martei

et al. 2023

JCO Global Oncology

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“…Poor cancer survival among PLWH likely stems from a nexus of disparities, including social or structural determinants of health limited access to cancer treatment and HIV‐related immunologic changes leading to accelerated tumor development and progression. Although delayed diagnosis and poorer access to standard oncologic treatments contribute, survival differences persist even after accounting for these factors 90‐94 . It should be noted, however, that PLWH can have similar outcomes to those without HIV in high‐ and low‐resource settings.…”

Section: Cancer Treatment and Survivalmentioning

confidence: 99%

“…Although delayed diagnosis and poorer access to standard oncologic treatments contribute, survival differences persist even after accounting for these factors. [90][91][92][93][94] It should be noted, however, that PLWH can have similar outcomes to those without HIV in high-and low-resource settings. For example, survival among PLWH who are provided guideline-concordant care appears comparable to that in people without HIV for Hodgkin lymphoma, aggressive subtypes of NHL and anal cancer.…”

Section: Cancer Treatment and Survivalmentioning

confidence: 99%

State of the science and future directions for research on HIV and cancer: Summary of a joint workshop sponsored by IARC and NCI

Engels,

Shiels,

Barnabas

et al. 2023

Intl Journal of Cancer

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An estimated 38 million people live with human immunodeficiency virus (HIV) worldwide and are at excess risk for multiple cancer types. Elevated cancer risks in people living with HIV (PLWH) are driven primarily by increased exposure to carcinogens, most notably oncogenic viruses acquired through shared transmission routes, plus acceleration of viral carcinogenesis by HIV‐related immunosuppression. In the era of widespread antiretroviral therapy (ART), life expectancy of PLWH has increased, with cancer now a leading cause of co‐morbidity and death. Furthermore, the types of cancers occurring among PLWH are shifting over time and vary in their relative burden in different parts of the world. In this context, the International Agency for Research on Cancer (IARC) and the US National Cancer Institute (NCI) convened a meeting in September 2022 of multinational and multidisciplinary experts to focus on cancer in PLWH. This report summarizes the proceedings, including a review of the state of the science of cancer descriptive epidemiology, etiology, molecular tumor characterization, primary and secondary prevention, treatment disparities and survival in PLWH around the world. A consensus of key research priorities and recommendations in these domains is also presented.

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“…However, they are diagnosed at younger ages and at more advanced stages of disease 56,57 . In North American and sub‐Saharan African WWH, survival rates were lower than in uninfected women, even after adjusting for classic prognostic risk factors and, in the USA study, for specific cancer treatments 57,58 …”

Section: Screening For Breast Cancermentioning

confidence: 99%

Cancer screening in people living with HIV

Masiá,

Gutiérrez‐Ortiz de la Tabla,

Gutiérrez

2023

Cancer Medicine

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BackgroundCancer is the leading cause of mortality in people living with HIV (PWH) and is expected to account for a growing fraction of deaths as PWH age.MethodsIn this literature review, we have compiled the most recent developments in cancer screening and screening performance in PWH, which are currently primarily implemented in well‐resourced settings. This includes an assessment of the associated benefits, harms, and cost‐effectiveness. The article also addresses unmet needs and potential strategies for tailored screening in the HIV population.FindingsIncidence and mortality due to screenable cancer are higher in PWH than in the general population, and diagnosis is frequently made at younger ages and/or at more advanced stages, the latter amenable to improved screening. Adequate evidence on the benefits of screening is lacking for most cancers in the HIV population, in whom standard practice may be suboptimal. While cancer surveillance has helped reduce mortality in the general population, and interest in risk‐based strategies is growing, implementation of screening programs in the HIV care settings remains low.InterpretationGiven the devastating consequences of a late diagnosis, enhancing early detection of cancer is essential for improving patient outcomes. There is an urgent need to extend the investigation in cancer screening performance to PWH, evaluating whether personalized measures according to individual risk could result in higher efficiency and improve patient outcomes.

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Disparities in breast cancer survival between women with and without HIV across sub-Saharan Africa (ABC-DO): a prospective, cohort study

Cited by 16 publications

References 31 publications

Survival Disparities Between Patients with Breast Cancer With and Without HIV: A Research Framework

Survival Disparities Between Patients with Breast Cancer With and Without HIV: A Research Framework

State of the science and future directions for research on HIV and cancer: Summary of a joint workshop sponsored by IARC and NCI

Cancer screening in people living with HIV

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