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May 21, 2008
Anal and Other Cancer Rates Higher in HIV
People living with HIV are being diagnosed with many types of cancers at rates that are much higher than in the general population, say the authors of a study to be published in a forthcoming issue of the Annals of Internal Medicine.
Pragna Patel, MD, MPH, from the Centers for Disease Control and Prevention (CDC) in Atlanta, and her colleagues analyzed cancer data involving 54,780 HIV-positive people enrolled in two cohorts: the Adult and Adolescent Spectrum of HIV Disease Project and the HIV Outpatient Study. These data were compared with cancer rates within the general U.S. population.
Patel’s team found that rates of two AIDS-related cancers fell sharply between the early 1990s and 2003. Compared with its occurrence in the general population, new reports of Kaposi’s sarcoma (KS) were 200 times higher among HIV-positive people in 1992. By 2003, people living with HIV were still more likely to develop KS, but at approximately half the rate seen 10 years earlier.
Rates of non-Hodgkin’s lymphoma (NHL) among people with HIV were 80 times higher than the rate in the general population in 1992. By 2003, NHL was still more common among people with HIV, but only 20 times more likely.
Though the rates of liver cancer and cervical cancer have also fallen somewhat since the introduction of combination antiretroviral (ARV) therapy, they are still higher in people with HIV than in the general population. The rate of liver cancer is still nearly seven times higher; the cervical cancer rate is 10 times higher.
Other cancer rates have increased since the early days of the epidemic. New cases of anal cancer in people with HIV have nearly doubled and are now nearly 60 times higher than in the general public. Melanoma rates also doubled and are now three times higher than in the general public. Hodgkin’s lymphoma rates, once 12 times higher compared with the general population in the early 1990s, are now 18 times higher. Rates of colon cancer, lung cancer and oral cancer are all between 2.5 and 3.5 times higher in people with HIV than the general public.
Only prostate cancer is diagnosed less often in people with HIV than the general population. The rate among HIV-positive people is rising, however, and the proportion of HIV-positive men who are 60 and older, when prostate cancer is most commonly diagnosed, is growing.
