HIV Infection, Immunosuppression, and Age at Diagnosis of Non-AIDS-Defining Cancers

Shiels, Meredith S.; Althoff, Keri N.; Pfeiffer, Ruth M.; Achenbach, Chad; Abraham, Alison G.; Castilho, Jessica L; Cescon, Angela; D’Souza, Gypsyamber; Dubrow, Robert; Eron, Joseph J.; Gebo, Kelly A.; Gill, M. John; Goedert, James J.; Grover, Surbhi; Hessol, Nancy A.; Justice, Amy C.; Kitahata, Mari M.; Mayor, Angel M.; Moore, Richard D.; Napravnik, Sonia; Novak, Richard M.; Thorne, Jennifer E.; Silverberg, Michael J.; Engels, Eric A.

doi:10.1093/cid/ciw764

Cited by 68 publications

(74 citation statements)

References 30 publications

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“…A notable finding among African Americans in our study was the difference in age of young-onset prostate cancer diagnoses by HIV-infection status: age 50–54 years in HIV-negative subjects vs. 41–50 years in HIV-positive subjects (p=0.11). Although this difference in age at diagnosis was not statistically significant, several other studies also noted a trend toward younger age at prostate cancer diagnosis in HIV-infected compared to uninfected African American men (5, 19–21). Further studies are warranted to evaluate whether HIV-infection status is associated with a younger age at prostate cancer diagnosis among men ages 40–55.…”

Section: Discussionmentioning

confidence: 62%

“…A recent study in the largest HIV cohort in North America found that while age at prostate cancer diagnosis was younger among HIV-infected subjects, the difference was not statistically significant (21); findings were inconclusive with respect to young-onset prostate cancer in groups by HIV status because age was examined in 10-year bins rather than comparing age of young-onset prostate cancer cases by HIV status. Young-onset prostate cancers diagnosed before age 55 are biologically and genetically distinct compared to prostate cancers diagnosed in older men (8, 22).…”

Section: Introductionmentioning

confidence: 99%

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Racial differences in prostate cancer risk in young HIV-positive and HIV-negative men: a prospective cohort study

Dutta

Uno

Holman

et al. 2017

Cancer Causes Control

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Purpose African American men have the highest incidence of prostate cancer among ethnic groups, and racial disparity is highest in younger men. Prostate cancer prevalence is rising in HIV-infected men due to improved survival on antiretroviral therapies, yet little is known about racial differences in prostate cancer risk by HIV-infection status and age. Methods Prospective cohort study of prostate cancer risk in 2800 HIV-infected and -uninfected men who have sex with men (MSM) ages 40–70 (22% African American) in the Multicenter AIDS Cohort Study from 1996–2010. Poisson regression models were used to examine associations between race or HIV-infection status and prostate cancer risk among men ages 40–70, 40–55, and 56–70. Results Among men ages 40–70, incidence rates (IR) per 100,000 person years were 169 among all men and 276 among African American HIV-infected men. Prostate cancer risk was similar by HIV-infection status (IRR 1.0, 95% CI 0.55–1.82), but nearly 3-fold higher in African Americans compared to non-African Americans in adjusted models (IRRs 2.66 and 3.22, 95% CIs 1.36–5.18 and 1.27–8.16 for all or HIV-infected men, respectively). Racial disparity in prostate cancer risk was greatest in African American men ages 40–55 (adjusted IRR 3.31, 95% CI 1.19–9.22). Prostate cancer risk showed associations with family history of prostate cancer (p =0.001), but not heavy smoking, androgen supplement use, or HIV-related factors. Conclusions Among MSM, African American HIV-positive and HIV-negative men ages 40–55 have nearly a 3-fold increased risk of young-onset prostate cancer compared to non-African American men, highlighting the need to make informed decisions about screening in this population.

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Racial differences in prostate cancer risk in young HIV-positive and HIV-negative men: a prospective cohort study

Dutta

Uno

Holman

et al. 2017

Cancer Causes Control

View full text Add to dashboard Cite

show abstract

“…Shiels, M. S et al's findings supports our study, they found cancer that usually occur with advanced age to be occurring among young person's infected with HIV. (24) Crum-Cianflone, N had a contrary finding in their study, cancer in the HIV infected was associated with increasing age. (25) This could also be related to the age at which persons get infected with HIV in their setting.…”

Section: Discussionmentioning

confidence: 73%

Cancers among HIV Infected Patients: A Reason for Routine Screening

M.W¹,

Ale²,

A.H³

et al. 2017

IOSR JDMS

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“…11–14 HIV increases the risk of lung cancer through mechanisms likely involving chronic inflammation, immunomodulation, and other infections. 11,15–19 Lung cancer is the leading cause of cancer death among PLWH on ART, and is among the leading causes of death overall in this population.…”

Section: Introductionmentioning

confidence: 99%

Lung Cancer Mortality Associated With Smoking and Smoking Cessation Among People Living With HIV in the United States

et al. 2017

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IMPORTANCE Lung cancer has become a leading cause of death among people living with human immunodeficiency virus (HIV) (PLWH). Over 40% of PLWH in the United States smoke cigarettes; HIV independently increases the risk of lung cancer.OBJECTIVE To project cumulative lung cancer mortality by smoking exposure among PLWH in care.DESIGN Using a validated microsimulation model of HIV, we applied standard demographic data and recent HIV/AIDS epidemiology statistics with specific details on smoking exposure, combining smoking status (current, former, or never) and intensity (heavy, moderate, or light). We stratified reported mortality rates attributable to lung cancer and other non-AIDS-related causes by smoking exposure and accounted for an HIV-conferred independent risk of lung cancer. Lung cancer mortality risk ratios (vs never smokers) for male and female current moderate smokers were 23.6 and 24.2, respectively, and for those who quit smoking at age 40 years were 4.3 and 4.5. In sensitivity analyses, we accounted for nonadherence to antiretroviral therapy (ART) and for a range of HIV-conferred risks of death from lung cancer and from other non-AIDS-related diseases (eg, cardiovascular disease). MAIN OUTCOMES AND MEASURESCumulative lung cancer mortality by age 80 years (stratified by sex, age at entry to HIV care, and smoking exposure); total expected lung cancer deaths, accounting for nonadherence to ART. RESULTS Among 40-year-old men with HIV, estimated cumulative lung cancer mortality for heavy, moderate, and light smokers who continued to smoke was 28.9%, 23.0%, and 18.8%, respectively; for those who quit smoking at age 40 years, it was 7.9%, 6.1%, and 4.3%; and for never smokers, it was 1.6%. Among women, the corresponding mortality for current smokers was 27.8%, 20.9%, and 16.6%; for former smokers, it was 7.5%, 5.2%, and 3.7%; and for never smokers, it was 1.2%. ART-adherent individuals who continued to smoke were 6 to 13 times more likely to die from lung cancer than from traditional AIDS-related causes, depending on sex and smoking intensity. Due to greater AIDS-related mortality risks, individuals with incomplete ART adherence had higher overall mortality but lower lung cancer mortality. Applying model projections to the approximately 644 200 PLWH aged 20 to 64 in care in the United States, 59 900 (9.3%) are expected to die from lung cancer if smoking habits do not change.CONCLUSIONS AND RELEVANCE Those PLWH who adhere to ART but smoke are substantially more likely to die from lung cancer than from AIDS-related causes.

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HIV Infection, Immunosuppression, and Age at Diagnosis of Non-AIDS-Defining Cancers

Cited by 68 publications

References 30 publications

Racial differences in prostate cancer risk in young HIV-positive and HIV-negative men: a prospective cohort study

Racial differences in prostate cancer risk in young HIV-positive and HIV-negative men: a prospective cohort study

Cancers among HIV Infected Patients: A Reason for Routine Screening

Lung Cancer Mortality Associated With Smoking and Smoking Cessation Among People Living With HIV in the United States

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