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Trends in survival after cancer diagnosis among HIV ‐infected individuals between 1992 and 2009. Results from the FHDH‐ANRS CO 4 cohort
Author(s) -
Hleyhel Mira,
Belot Aurélien,
Bouvier AnneMarie,
Tattevin Pierre,
Pacanowski Jérôme,
Genet Philippe,
De Castro Nathalie,
Berger JeanLuc,
Dupont Caroline,
Lavolé Armelle,
Pradier Christian,
Salmon Dominique,
Simon Anne,
Martinez Valérie,
Spano JeanPhilippe,
Costagliola Dominique,
Grabar Sophie
Publication year - 2015
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.29603
Subject(s) - medicine , anal cancer , lung cancer , population , cancer , proportional hazards model , hazard ratio , cart , survival analysis , oncology , relative survival , cohort , liver cancer , sarcoma , immunology , cancer registry , pathology , confidence interval , mechanical engineering , environmental health , engineering
Although the decline in cancer mortality rates with the advent of combination antiretroviral therapy (cART) in HIV‐infected individuals can be mostly explained by a decrease in cancers incidence, we looked here if improved survival after cancer diagnosis could also contribute to this decline. Survival trends were analyzed for most frequent cancers in the HIV‐infected population followed in the French Hospital Database on HIV: 979 and 2,760 cases of visceral and non‐visceral Kaposi's sarcoma (KS), 2,339 and 461 cases of non‐Hodgkin lymphoma (NHL) and Hodgkin's lymphoma (HL), 446 lung, 312 liver and 257 anal cancers. Five‐year Kaplan–Meier survival rates were estimated for four periods: 1992–1996, 1997–2000, 2001–2004 and 2005–2009. Cox proportional hazard models were used to compare survival across the periods, after adjustment for confounding factors. For 2001–2004, survival was compared to the general population after standardization on age and sex. Between the pre‐cART (1992–1996) and early‐cART (1997–2000) periods, survival improved after KS, NHL, HL and anal cancer and remained stable after lung and liver cancers. During the cART era, 5‐year survival improved after visceral and non‐visceral KS, NHL, HL and liver cancer, being 83, 92, 65, 87 and 19% in 2005–2009, respectively, and remained stable after lung and anal cancers, being 16 and 65%, respectively. Compared with the general population, survival in HIV‐infected individuals in 2001–2004 was poorer for hematological malignancies and similar for solid tumors. For hematological malignancies, survival continues to improve after 2004, suggesting that the gap between the HIV‐infected and general populations will close in the future.