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Disparities in human papillomavirus–related cancer incidence and survival among human immunodeficiency virus–infected Hispanics living in the United States
Author(s) -
Ortiz Ana P.,
Engels Eric A.,
NoguerasGonzález Graciela M.,
ColónLópez Vivian,
SotoSalgado Marievelisse,
Vargas Alicia,
Machin Mark,
Shiels Meredith S.
Publication year - 2018
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.31702
Subject(s) - medicine , cancer , cervical cancer , incidence (geometry) , population , hazard ratio , demography , anal cancer , confidence interval , rate ratio , environmental health , physics , sociology , optics
Background Human papillomavirus (HPV) causes 10% of cancers among human immunodeficiency virus (HIV)–infected people in the United States. Because Hispanics are disproportionally affected by the HIV epidemic and by infection‐related cancers, this study compared incidence rates for HPV‐related cancers and survival between Hispanics and non‐Hispanic whites (NHWs) and non‐Hispanic blacks (NHBs) in the HIV‐infected US population. Methods Based on data from the HIV/AIDS Cancer Match Study, standardized incidence ratios (SIRs) were used to estimate cancer risk in HIV‐infected Hispanics and the general US Hispanic population. Among HIV‐infected people, cancer rates were compared with incidence rate ratios (IRRs), and survival was compared with hazard ratios between Hispanics and NHWs and NHBs. Results Five hundred two HPV‐related cancers occurred in 864,067 person‐years of follow‐up among HIV‐infected Hispanics. Except for oropharyngeal cancer, the risk of HPV‐related cancers was higher among HIV‐infected Hispanics than in the general population (SIR range, 3.59 [cervical cancer] to 18.7 [anal cancer in men]). Among HIV‐infected females, Hispanics had higher cervical cancer rates than NHWs (IRR, 1.70; 95% confidence interval [CI], 1.19‐2.43) but lower vulvar cancer rates than NHWs (IRR, 0.40; 95% CI, 0.24‐0.67) and NHBs (IRR, 0.62; 95% CI, 0.41‐0.95). Among HIV‐infected males, Hispanics had higher penile cancer rates than NHWs (IRR, 2.60; 95% CI, 1.36‐4.96) but lower anal cancer rates than NHWs (IRR, 0.54; 95% CI, 0.46‐0.63) and NHBs (IRR, 0.65; 95% CI, 0.56‐0.77). Among HIV‐infected Hispanics, 5‐year survival was greater than 50% across HPV‐related cancer types, with no major differences by racial/ethnic group. Conclusions HIV‐infected Hispanics have an elevated risk for HPV‐related cancers. Similarly to the general population, HIV‐infected Hispanics have higher rates of cervical and penile cancer than NHWs and NHBs. HPV vaccination should be promoted among HIV‐infected individuals to reduce the burden of HPV‐related cancers.