Biggar Robert J, Kirby Katharine A, Atkinson Jonnae, McNeel Timothy S, Engels Eric
From *Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
J Acquir Immune Defic Syndr. 2004 Jul 1;36(3):861-8. doi: 10.1097/00126334-200407010-00014.
Cancer risks in persons with AIDS are increased, but risks in elderly persons with AIDS (EPWAs) have not been previously described.
To determine the profile of cancer risks in EPWAs.
Using AIDS data from 1981-1996, 8828 EPWAs were identified (60+ years old) and their records were linked to data in local cancer registries, finding 1142 cases. Expected case numbers were derived from the cancer incidence in the population matched for age, sex, race, calendar year, and registry.
Compared with the general population, the relative risk (RR) for Kaposi sarcoma was 545 (95% CI, 406-717) in the 2 years after AIDS onset. For non-Hodgkin lymphoma, the RR was 24.6 (7.5-80.3). No cervical cancers were reported in this interval. From 60 months before to 27 months after AIDS onset, the RR of non-AIDS-defining cancers (n = 548) was 1.3 (1.2-1.4). The cancer types occurring at significant excess during this period were similar to those in younger adults with AIDS: Hodgkin lymphoma (RR: 13.1), anal cancer (8.2), liver cancer (3.9), multiple myeloma (2.7), leukemia (2.4), and lung cancer (1.9). However, none was significantly elevated in the 2 years after the AIDS onset. Prostate cancer risk was low overall (RR: 0.8; 0.6-0.9).
The profile of cancer risks in EPWAs generally resembled that in younger adults with AIDS, although RRs were lower because of higher background incidence rates. We speculate that prostate cancer risk was low because of reduced screening for this cancer in EPWAs.
艾滋病患者的癌症风险会增加，但老年艾滋病患者（EPWAs）的风险此前尚未得到描述。
确定老年艾滋病患者的癌症风险特征。
利用1981年至1996年的艾滋病数据，识别出8828名老年艾滋病患者（60岁及以上），并将他们的记录与当地癌症登记处的数据相链接，发现了1142例病例。预期病例数来自于按年龄、性别、种族、日历年份和登记处匹配的人群中的癌症发病率。
与普通人群相比，艾滋病发病后2年内卡波西肉瘤的相对风险（RR）为545（95%可信区间，406 - 717）。非霍奇金淋巴瘤的RR为24.6（7.5 - 80.3）。在此期间未报告宫颈癌病例。从艾滋病发病前60个月到发病后27个月，非艾滋病定义癌症（n = 548）的RR为1.3（1.2 - 1.4）。在此期间显著增加的癌症类型与年轻艾滋病患者相似：霍奇金淋巴瘤（RR：13.1）、肛门癌（8.2）、肝癌（3.9）、多发性骨髓瘤（2.7）、白血病（2.4）和肺癌（1.9）。然而，在艾滋病发病后2年内，这些癌症均无显著升高。总体前列腺癌风险较低（RR：0.8；0.6 - 0.9）。
老年艾滋病患者的癌症风险特征总体上与年轻艾滋病患者相似，尽管由于背景发病率较高，RR较低。我们推测前列腺癌风险较低是因为老年艾滋病患者对该癌症的筛查减少。
