Spectrum and Incidence Trends of AIDS- and Non–AIDS-Defining Cancers between 2010 and 2015 in the French Dat'AIDS Cohort

Abstract

Background: Cancer risk is higher in people living with HIV (PLWH) compared with the general population, and cancers related to age are expected to be most prevalent. Methods: We determined the spectrum and incidence rates of AIDS-defining cancers (ADC) and non–AIDS-defining cancers (NADC) and of lung, Hodgkin lymphoma (HL), head and neck (HNC), colon–rectum, anal, liver, breast, prostate, and urinary bladder cancers between January 2010 and December 2015 in the French Dat'AIDS cohort. Incidence rates were calculated by year and compared using the χ2 test for linear trend. Standardized incidence ratios [SIR (95% confidence interval)] were calculated relative to the French general population. Results: Among 44,642 patients, corresponding to 180,216.4 person-years (PY), 1,440 cancer cases occurred in 1,314 patients. ADC incidence was 191.4 (172.3–212.7)/105 PY and declined over time overall and in men, whereas NADC incidence was higher [548.8 (515.6–584.1)/105 PY] and did not change. In men, non-Hodgkin lymphoma was the most common cancer, but prostate cancer had the highest incidence among NADCs. Breast cancer was the most common cancer in women. SIRs were higher for cervical cancer [1.93 (1.18–3.14)], HNC in women [2.4 (1.4–4.2)], liver [overall: 3.8 (3.1–4.6); men: 3.2 (2.5–4.0); women: 12.9 (8.3–20.0)], and HL [overall: 13.8 (11.1–17.1); men: 16.2 (12.9–20.4); women: 6.2 (3.22–11.9)] but lower for lung [overall: 0.7 (0.6–0.9); men: 0.7 (0.5–0.8)], prostate [0.6 (0.5–0.7)], and breast cancers [0.6 (0.4–0.7)]. Conclusions: Spectrum of NADCs has changed, with prostate and breast cancers becoming the most common despite their lower SIR. Impact: These results confirm the need to maintain regular epidemiologic cancer monitoring in order to update screening guidelines.

Clinical and Therapeutic Implications of Epstein–Barr Virus in HIV-Related Lymphomas

“…People living with HIV (PLWH) are at higher risk of developing aggressive B-cell lymphomas than the general population, and B-cell non-Hodgkin lymphoma (NHL) is currently the most frequent AIDS-defining cancer (ADC) [ 1 , 2 ]. Among NHL, diffuse large B-cell lymphoma (DLBCL) is the most common, including primary central nervous system lymphoma (PCNSL), followed by Burkitt lymphoma (BL).…”

Prevalence and Spectrum of Second Primary Malignancies among People Living with HIV in the French Dat’AIDS Cohort

“…In this large cohort of HIV-positive cancer survivors with a median follow-up time of 9 years since the first cancer event [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ], the SPC prevalence was 9.1% (444/4855), confirming that SPCs are a major concern in this population.…”

“…An increased risk for certain types of primary cancers among people living with HIV (PLWH) was demonstrated in the last few decades, although the level of risk has diminished for some cancers in recent years due to better control of viral replication and improvement in immune status [ 9 , 10 , 11 ]. Given the increasing life expectancy of PLWH, a steady increase in SPCs has been reported in the US [ 12 ].…”

Immune Reconstitution Inflammatory Syndrome Associated Kaposi Sarcoma

“…In resource-rich countries, KS incidence has declined substantially since the advent of effective ART [ 18 , 19 ], but it remains a frequent cancer among PLWH [ 20 ], including those on ART with a sustained undetectable HIV viral load [ 21 , 22 , 23 ] and in late presenters, as observed between 2010 and 2015 in the French Dat’AIDS cohort [ 24 ]. Furthermore, KS is still an important cause of death [ 25 ].…”