Recent cancer incidence trends in an observational clinical cohort of HIV-infected patients in the US, 2000 to 2011

Yanik, Elizabeth L.; Tamburro, Kristen M.; Eron, Joseph J.; Damania, Blossom; Napravnik, Sonia; Dittmer, Dirk P.

doi:10.1186/1750-9378-8-18

Cited by 23 publications

(14 citation statements)

References 27 publications

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“…Five-year survival increased from 63% during the pre-HIV era to 72% during HAART. Yanik et al 28 examined more recent trends linking the University of North Carolina (NC) Center for AIDS Research HIV Clinical Cohort, an observational clinical cohort of 3141 HIV-infected patients 30% of whom were female, with the NC Cancer registry data between 2000 and 2011. Across 15,022 person-years of follow-up, 202 cancers were identified with most being virus-related (incidence rate (IR) per 100,000 person-years was 1345; 95% CI: 1166-1544).…”

Section: Anal Hpv Infection and Disease In Womenmentioning

confidence: 99%

Screening for Anal Cancer in Women

Moscicki

Darragh

Berry-Lawhorn

et al. 2015

Journal of Lower Genital Tract Disease

135

122

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Objective The incidence of anal cancer is higher in women than men in the general population and has been increasing for several decades. Similar to cervical cancer, most anal cancers are associated with human papillomavirus (HPV) and it is believed that anal cancers are preceded by anal high-grade squamous intraepithelial lesions (HSIL). Our goal was to summarize the literature on anal cancer, HSIL and HPV infection in women, and provide screening recommendations in women. Methods A group of experts convened by the ASCCP and the International Anal Neoplasia Society reviewed the literature on anal HPV infection, anal SIL and anal cancer in women. Results Anal HPV infection is common in women but is relatively transient in most. The risk of anal HSIL and cancer varies considerably by risk group, with HIV-infected women and those with a history of lower genital tract neoplasia (LGTN) at highest risk compared with the general population. Conclusions While there are no data yet to demonstrate that identification and treatment of anal HSIL leads to reduced risk of anal cancer, women in groups at the highest risk should be queried for anal cancer symptoms and have digital anorectal examinations to detect anal cancers. HIV-infected women and women with LGTN, may be considered for screening with anal cytology with triage to treatment if HSIL is diagnosed. Healthy women with no known risk factors or anal cancer symptoms do not need to be routinely screened for anal cancer or anal HSIL.

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Section: Anal Hpv Infection and Disease In Womenmentioning

confidence: 99%

Screening for Anal Cancer in Women

Moscicki

Darragh

Berry-Lawhorn

et al. 2015

Journal of Lower Genital Tract Disease

135

122

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“…Studies of adjusted IR time trends that classified NADC into broad groupings have produced inconsistent results [20, 23–25]. Evidence supports decreasing trends for lung cancer and Hodgkin lymphoma and an increasing trend for liver cancer, but results for anal cancer have been inconsistent; many nonsignificant trends for specific NADC have been observed, perhaps due to insufficient statistical power [11, 16–19, 21–23, 26]. The ADC adjusted IR has continued to decline during the ART era [9, 11, 17, 18, 20, 23, 24].…”

Section: Introductionmentioning

confidence: 99%

Time trends in cancer incidence in persons living with HIV/AIDS in the antiretroviral therapy era

Park

Tate

Sigel

et al. 2016

Aids

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Objective Utilizing the Veterans Aging Cohort Study, the largest HIV cohort in North America, we conducted one of the few comprehensive comparisons of cancer incidence time trends in HIV-infected (HIV+) versus uninfected persons during the antiretroviral therapy (ART) era. Design Prospective cohort study. Methods We followed 44,787 HIV+ and 96,852 demographically-matched uninfected persons during 1997–2012. We calculated age-, sex-, and race/ethnicity-standardized incidence rates (IR) and incidence rate ratios (IRR, HIV+ versus uninfected) over four calendar periods with IR and IRR period trend p-values for cancer groupings and specific cancer types. Results We observed 3,714 incident cancer diagnoses in HIV+ and 5,760 in uninfected persons. The HIV+ all cancer crude IR increased between 1997–2000 and 2009–2012 (p-trend=0.0019). However, after standardization, we observed highly significant HIV+ IR declines for all cancer (25% decline; p-trend<0.0001), AIDS-defining cancers (ADC; 55% decline; p-trend<0.0001), non-AIDS-defining cancers (NADC; 15% decline; p-trend=0.0003), and non-virus-related NADC (20% decline; p-trend<0.0001); significant IRR declines for all cancer (from 2.0 to 1.6; p-trend<0.0001), ADC (from 19 to 5.5; p-trend<0.0001), and non-virus-related NADC (from 1.4 to 1.2; p-trend=0.049); and borderline significant IRR declines for NADC (from 1.6 to 1.4; p-trend=0.078) and virus-related NADC (from 4.9 to 3.5; p-trend=0.071). Conclusion Improved HIV care resulting in improved immune function most likely contributed to the HIV+ IR and the IRR declines. Further promotion of early and sustained ART, improved ART regimens, reduction of traditional cancer risk factor (e.g., smoking) prevalence, and evidence-based screening could contribute to future cancer incidence declines among HIV+ persons.

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“…The proportion of cancer cases in this study that was ADCs was lower than previously reported [22–24]. Among HIV-infected cancer cases, about half were ADCs in an Italian study [22], one-third were ADCs in a single institution study in the US [23], and 60% were ADCs in an Australian observational database [24]. Our finding of the decline with age in the proportion of cancers that are ADCs is consistent with reports on the age-related decline in cancers attributable to infectious agents [25, 26].…”

Section: Discussionmentioning

confidence: 64%

Risk of Cancer among Commercially Insured HIV-Infected Adults on Antiretroviral Therapy

Lee

Dhakal

Casper

et al. 2016

Journal of Cancer Epidemiology

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The objective of this study was to explore the cancer incidence rates among HIV-infected persons with commercial insurance who were on antiretroviral therapy and compare them with those rates in the general population. Paid health insurance claims for 63,221 individuals 18 years or older, with at least one claim with a diagnostic code for HIV and at least one filled prescription for an antiretroviral medication between January 1, 2006, and September 30, 2012, were obtained from the LifeLink® Health Plan Claims Database. The expected number of cancer cases in the general population for each gender-age group (<30, 30–39, 40–49, 50–59, and >60 years) was estimated using incidence rates from the Surveillance Epidemiology and End Results (SEER) program. Standardized incidence ratios (SIRs) were estimated using their 95% confidence intervals (CIs). Compared to the general population, incidence rates for HIV-infected adults were elevated (SIR, 95% CI) for Kaposi sarcoma (46.08; 38.74–48.94), non-Hodgkin lymphoma (4.22; 3.63–4.45), Hodgkin lymphoma (9.83; 7.45–10.84), and anal cancer (30.54; 25.62–32.46) and lower for colorectal cancer (0.69; 0.52–0.76), lung cancer (0.70; 0.54, 0.77), and prostate cancer (0.54; 0.45–0.58). Commercially insured, treated HIV-infected adults had elevated rates for infection-related cancers, but not for common non-AIDS defining cancers.

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Recent cancer incidence trends in an observational clinical cohort of HIV-infected patients in the US, 2000 to 2011

Cited by 23 publications

References 27 publications

Screening for Anal Cancer in Women

Screening for Anal Cancer in Women

Time trends in cancer incidence in persons living with HIV/AIDS in the antiretroviral therapy era

Risk of Cancer among Commercially Insured HIV-Infected Adults on Antiretroviral Therapy

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