Increased risk of histologically defined cancer subtypes in human immunodeficiency virus–infected individuals

Abstract

Background Malignancies that occur in excess among HIV-infected individuals may be caused by immunosuppression or infections. Because histologically-defined cancer subtypes have not been systematically evaluated, we assessed their risk among people with AIDS. Methods Analyses included 569,268 people with AIDS from the HIV/AIDS Cancer Match Study, a linkage of 15 U.S. population-based HIV/AIDS and cancer registries during 1980–2007. Standardized incidence ratios (SIRs) were estimated to compare cancer risk in people with AIDS to the general population overall, and stratified by age, calendar period (a proxy of changing HIV therapies) and time since AIDS (a proxy of immunosuppression). Results Sixteen individual cancer histologies or histology groupings manifested significantly elevated SIRs. Risks were most elevated for adult T-cell leukemia/lymphoma (SIR=11.3), neoplasms of histiocytes and accessory lymphoid cells (SIR=10.7), giant cell carcinoma (SIR=7.51) and leukemia not otherwise specified (NOS) (SIR=6.69). SIRs ranged from 1.4 to 4.6 for spindle cell carcinoma, bronchioloalveolar adenocarcinoma, adnexal and skin appendage neoplasms, sarcoma NOS, spindle cell sarcoma, leiomyosarcoma, mesothelioma, germ cell tumors, plasma cell tumors, immunoproliferative diseases, acute lymphocytic leukemia and myeloid leukemias. For several of these cancer subtypes, we observed significant declines in SIRs across calendar periods (consistent with decreasing risk with improved HIV therapies) or increase in SIRs with time since AIDS (i.e., prolonged immunosuppression). Conclusions The elevated risk of certain cancer subtypes in people with AIDS may point to an etiologic role of immunosuppression or infection. Future studies are needed to further investigate these associations and evaluate candidate infectious agents.

Atopy and Specific Cancer Sites: a Review of Epidemiological Studies

“…Atopy is a hyperreactive immune response state; this hyper-reactivity could [53] Case-control 561 squamous cell cervical cancer Allergy OR 0.7 (0.6-0.9) bring about enhanced immune surveillance that inhibits the proliferation of abnormal cells. Evidence supporting the immune surveillance process stems from previous observations that immunosuppressed individuals have a higher incidence of malignant cancer [9][10][11]14]. Additionally, certain cancer mutations have been shown to be detected by the adaptive immune system, reflecting the ability of the immune system to naturally protect against cancer incidence and growth [8,12,13,15,16].…”

“…Atopy represents a hyper-reactive immune response state which could enhance immune surveillance, thus inhibiting abnormal cell growth. Specific cancer mutations have been observed to be identified by the adaptive immune system, and immunodeficiency has been linked to increased cancer [8][9][10][11][12][13][14][15][16].…”

Association of the polymorphisms of MMP-9 and TIMP-3 genes with thoracic aortic dissection in Chinese Han population

“…Second, the key mechanisms of TAD and other tissue-remodeling diseases are not exactly the same. For example, immunosuppression is crucial for cancer development, which is different from TAD formation [29] . Third, determining what causes these diseases is complex.…”

A critical review of the epidemiology of Agent Orange or 2,3,7,8-tetrachlorodibenzo-p-dioxin and lymphoid malignancies

“…In addition to HIV, which increases the risk of numerous NHL subtypes [35,36], other specific infectious agents are also etiologically linked to certain NHL subtypes. Causal relationships have been established between Epstein-Barr virus (EBV) and immunodeficiency-associated NHL, Burkitt lymphoma, and extranodal nasal natural killer/T-cell lymphoma; between human herpesvirus 8 (Kaposi sarcoma herpesvirus) and primary effusion lymphoma; between human T-cell lymphotropic virus 1 and adult T-cell leukemia/lymphoma; between Helicobacter pylori and gastric mucosaeassociated lymphoid tissue lymphoma; and between hepatitis C virus and certain B-cell NHL subtypes [37e40].…”