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Cancer incidence in the multicenter aids cohort study before and during the HAART era
Author(s) -
Seaberg Eric C.,
Wiley Dorothy,
MartínezMaza Otoniel,
Chmiel Joan S.,
Kingsley Lawrence,
Tang Yiwei,
Margolick Joseph B.,
Jacobson Lisa P.
Publication year - 2010
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.25530
Subject(s) - medicine , anal cancer , incidence (geometry) , multicenter aids cohort study , epidemiology , cancer , population , rate ratio , cohort , standardized mortality ratio , cohort study , cancer registry , oncology , immunology , human immunodeficiency virus (hiv) , antiretroviral therapy , viral load , confidence interval , physics , environmental health , optics
BACKGROUND: The incidence of Kaposi sarcoma (KS) and non‐Hodgkin lymphoma (NHL) among human immunodeficiency virus (HIV)‐infected individuals declined after the introduction of highly active antiretroviral therapy (HAART) in the mid‐1990s, but the cancer risk associated with HIV infection during the HAART era remains to be clarified. METHODS: Cancer incidence among HIV‐infected and HIV‐uninfected participants in the Multicenter AIDS (acquired immunodeficiency syndrome) Cohort Study (MACS) between 1984 and 2007 was compared with the expected incidence using US population‐based data from the Surveillance, Epidemiology, and End Results (SEER) program. Age‐ and race‐adjusted cancer incidence rates were also compared HIV by status and over time within the MACS. Exact statistical methods were used for all analyses. RESULTS: A total of 933 incident cancers were observed during 77,320 person‐years of follow‐up. Compared with SEER, MACS HIV‐infected men had significantly ( P < .05) elevated rates of KS (standardized incidence ratio [SIR], 139.10), NHL (SIR, 36.80), Hodgkin lymphoma (HL)(SIR, 7.30), and anal cancer (SIR, 25.71). Within MACS, HIV infection was found to be independently associated with each of these cancers across the entire follow‐up period, and KS (incidence rate ratio [IRR], 54.93), NHL (IRR, 11.18), and anal cancer (IRR, 18.50) were each found to be significantly elevated among HIV‐infected men during the HAART era. Among these men, the incidence of KS and NHL declined (IRR, 0.13 and 0.23, respectively), the incidence of anal cancer increased (IRR, 5.84), and the incidence of HL remained statistically unchanged (IRR, 0.75) from the pre‐HAART to the HAART era. CONCLUSIONS: Cancer risk remains elevated among HIV‐infected men who have sex with men, highlighting the continuing need for appropriate cancer screening in this population. Cancer 2010. © 2010 American Cancer Society.