Risk of cancer in people with AIDS

Grulich, Andrew E.; Wan, Xinan; Law, Matthew; Coates, Marylon; Kaldor, John

doi:10.1097/00002030-199905070-00014

Cited by 182 publications

(111 citation statements)

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“…Failure to take this survival factor into account has a major impact on the relative risk estimates (Grulich et al, 1999;Engels et al, 2003). Consequently, estimates of the expected cancers, to which observed cases were compared, must take into account that some individuals with cancer died or were lost to follow-up before they developed AIDS.…”

Section: Measures Of Relative Riskmentioning

confidence: 99%

“…For presentation, ancestry was grouped as African and other. Expected numbers of cancer were calculated as the sum of stratum-specific products of background cancer incidence and person-months at risk among the PWA and were discounted for periods before AIDS onset to account for reduced survival following a cancer diagnosis (Breslow and Day, 1987;Grulich et al, 1999;Frisch et al, 2000;Engels et al, 2003). We calculated 95% confidence intervals (CI) assuming a Poisson distribution of the observed cancers (Breslow and Day, 1987).…”

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confidence: 99%

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Risk of breast, ovary, and uterine corpus cancers among 85 268 women with AIDS

et al. 2006

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By linking HIV/AIDS and cancer surveillance data in 12 US regions, breast and reproductive cancer risks with AIDS were compared to those in the general population. Trends in standardized incidence ratios (SIRs) were assessed by CD4 count, AIDS-relative time, and calendar time. Standardized incidence ratios were indirectly adjusted for cancer risk factors using data from AIDS cohort participants and the general population. With AIDS, 313 women developed breast cancer (SIR 0.69, 95% confidence interval (CI) 0.62 -0.77), 42 developed ovary cancer (SIR 1.05, 95% CI, 0.75 -1.42), and 31 developed uterine corpus cancer (SIR 0.57, 95% CI, 0.39 -0.81). Uterine cancer risk was reduced significantly after age 50 (SIR 0.33). Breast cancer risk was reduced significantly both before (SIR 0.71) and after (SIR 0.66) age 50, and was lower for local or regional (SIR 0.54) than distant (SIR 0.89) disease. Breast cancer risk varied little by CD4 count (P trend ¼ 0.47) or AIDS-relative time (P trend ¼ 0.14) or after adjustment for established cancer risk factors. However, it increased significantly between 1980 and 2002 (P trend ¼ 0.003), approaching the risk of the general population. We conclude that the cancer deficit reflected direct or indirect effects of HIV/AIDS and that anti-HIV therapy reduced these effects. Increasing numbers of women have been infected with human immunodeficiency virus (HIV) and now are living with the acquired immunodeficiency syndrome (AIDS). The effects of AIDS on women, particularly in the era of highly active antiretroviral therapy (HAART), are not well defined. In the era before HAART, the risks of developing Kaposi sarcoma, anal cancer, and perhaps lymphoma were lower for women than for men with AIDS (Beral and Newton, 1998;Goedert, 2000). Other than cervical cancer, no differences by gender have been reported for the few other malignancies found in excess among people with AIDS (PWA) (Goedert et al, 1998;Frisch et al, 2001).Breast cancer may occur less often in women with AIDS than in the general population (Goedert et al, 1998;Frisch et al, 2001). Ovary and uterine corpus cancers have not been associated with AIDS or other immune deficiencies, but weak associations or susceptible subgroups may have been overlooked because these malignancies are relatively rare. No previous study has evaluated the effects of improving anti-HIV therapies or whether differences in cancer incidence might merely reflect differences in known risk factors for cancer.Using population-based data, we have investigated whether the risk of breast, ovary, or uterine corpus cancers differ for women with AIDS, whether breast cancer risk differs with increasing severity or duration of immune deficiency, or with increasing availability and efficacy of anti-HIV therapies; also whether menopause or selected risk factors modify or explain any associations. MATERIALS AND METHODS Detection and definition of cancersFrom 2003 through 2005, we linked HIV/AIDS and cancer registration data (including name, race, sex, dates of birth and de...

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Section: Measures Of Relative Riskmentioning

confidence: 99%

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confidence: 99%

Risk of breast, ovary, and uterine corpus cancers among 85 268 women with AIDS

et al. 2006

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“…HIV is associated with many neoplasias, of which several are AIDS defining (non-Hodgkin's lymphoma, Kaposi syndrome, cervical carcinoma) [5,10]. Plasmacell malignancies are becoming more frequently noted in patients with HIV infection, although they are not yet AIDS-defining diseases [1,[4][5][6][7][8][9][13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

HIV and plasmablastic lymphoma manifesting in sinus, testicles, and bones: A further expansion of the disease spectrum

et al. 2004

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Patients with HIV infection are at increased risk for B-cell neoplasms and plasma cell dyscrasias. Both B cell and plasma cell tumors tend to be intermediate or high grade and are frequently associated with Epstein-Barr virus. Patients with HIV infection are also at higher risk of acquiring plasmablastic lymphoma. Until this time, only sinus, oral gastrointestinal, and lung manifestation have been noted. In this report we describe a 41-year-old male with HIV infection who developed multiple pleomorphic, extramedullary plasmablastic lymphomas associated with Epstein-Barr virus. We review the clinical and immunological features of his malignancy and thereby expand the spectrum of disease to include additional sites (bones, testicles) not previously reported. Am.

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“…5 In 1993, invasive cervical cancer (ICC) was added to the case definition of AIDS 5 on the basis of increased incidence of precancerous lesions in HIV-infected women; 6,7 however, although excess cases of ICC have been reported, to our knowledge no statistically significant increased incidence of cervical cancer in HIV-infected women has yet been demonstrated, especially in a cohort. 8 -11 Other cancers such as Hodgkin's disease, lung cancer and nonmelanomatous skin cancer have been suggested to be HIV-related, 6,12,13 but supporting data are based on studies in primarily male populations, and results have been inconsistent. 14,15 In addition, HIV serostatus is usually not known but is assumed to be negative in historic controls, making it difficult to develop firm conclusions about the difference in incidence between infected and uninfected persons.…”

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confidence: 99%

“…14,15 In addition, HIV serostatus is usually not known but is assumed to be negative in historic controls, making it difficult to develop firm conclusions about the difference in incidence between infected and uninfected persons. 16 -18 In studies matching AIDS case registry with cancer registry data, 7,12,13 results vary by study and region. Although the occurrence of AIDS-defining cancers is consistent across the studies, other cancers do not occur with consistency, indicating that there are most likely other factors contributing to an increase in a particular cancer in a given population; also, as with studies using historic controls, the number of women in such reports remains relatively small.…”

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confidence: 99%