1992年至2003年期间，美国艾滋病毒感染者中各类癌症的发病率与普通人群的比较。

Incidence of types of cancer among HIV-infected persons compared with the general population in the United States, 1992-2003.

作者信息

Patel Pragna, Hanson Debra L, Sullivan Patrick S, Novak Richard M, Moorman Anne C, Tong Tony C, Holmberg Scott D, Brooks John T

机构信息

Centers for Disease Control and Prevention, Emory University, and Northrop Grumman Information Technology, Atlanta, Georgia 30333, USA.

出版信息

Ann Intern Med. 2008 May 20;148(10):728-36. doi: 10.7326/0003-4819-148-10-200805200-00005.

DOI:10.7326/0003-4819-148-10-200805200-00005

PMID:18490686

Abstract

BACKGROUND

Persons who are HIV-infected may be at higher risk for certain types of cancer than the general population.

OBJECTIVE

To compare cancer incidence among HIV-infected persons with incidence in the general population from 1992 to 2003.

DESIGN

Prospective observational cohort studies.

SETTING

United States.

PATIENTS

54,780 HIV-infected persons in the Adult and Adolescent Spectrum of HIV Disease Project (47,832 patients) and the HIV Outpatient Study (6948 patients), who contributed 157,819 person-years of follow-up from 1992 to 2003, and 334,802,121 records from the Surveillance, Epidemiology, and End Results program of 13 geographically defined, population-based, central cancer registries.

MEASUREMENTS

Standardized rate ratios (SRRs) to compare cancer incidence in the HIV-infected population with standardized cancer incidence in the general population.

RESULTS

The incidence of the following types of non-AIDS-defining cancer was significantly higher in the HIV-infected population than in the general population: anal (SRR, 42.9 [95% CI, 34.1 to 53.3]), vaginal (21.0 [CI, 11.2 to 35.9]), Hodgkin lymphoma (14.7 [CI, 11.6 to 18.2]), liver (7.7 [CI, 5.7 to 10.1]), lung (3.3 [CI, 2.8 to 3.9]), melanoma (2.6 [CI, 1.9 to 3.6]), oropharyngeal (2.6 [CI, 1.9 to 3.4]), leukemia (2.5 [CI, 1.6 to 3.8]), colorectal (2.3 [CI, 1.8 to 2.9]), and renal (1.8 [CI, 1.1 to 2.7]). The incidence of prostate cancer was significantly lower among HIV-infected persons than the general population (SRR, 0.6 [CI, 0.4 to 0.8]). Only the relative incidence of anal cancer increased over time.

LIMITATIONS

Lower ascertainment of cancer in the HIV cohorts may result in a potential bias to underestimate rate disparities. Tobacco use as a risk factor and the effect of changes in cancer screening practices could not be evaluated.

CONCLUSION

The incidence of many types of non-AIDS-defining cancer was higher among HIV-infected persons than among the general population from 1992 to 2003.

摘要

背景

与普通人群相比，感染艾滋病毒的人患某些类型癌症的风险可能更高。

目的

比较1992年至2003年期间艾滋病毒感染者的癌症发病率与普通人群的发病率。

设计

前瞻性观察队列研究。

地点

美国。

患者

成人及青少年艾滋病毒疾病谱项目（47832例患者）和艾滋病毒门诊研究（6948例患者）中的54780名艾滋病毒感染者，他们在1992年至2003年期间提供了157819人年的随访数据，以及来自13个地理区域界定的、基于人群的中央癌症登记处的监测、流行病学和最终结果项目的334802121条记录。

测量指标

标准化率比（SRRs），用于比较艾滋病毒感染人群的癌症发病率与普通人群的标准化癌症发病率。

结果

艾滋病毒感染人群中以下类型的非艾滋病定义癌症的发病率显著高于普通人群：肛门癌（SRR，42.9[95%CI，34.1至53.3]）、阴道癌（21.0[CI，11.2至35.9]）、霍奇金淋巴瘤（14.7[CI，11.6至18.2]）、肝癌（7.7[CI，5.7至10.1]）、肺癌（3.3[CI，2.8至3.9]）、黑色素瘤（2.6[CI，1.9至3.6]）、口咽癌（2.6[CI，1.9至3.4]）、白血病（2.5[CI，1.6至3.8]）、结直肠癌（2.3[CI，1.8至2.9]）和肾癌（1.8[CI，1.1至2.7]）。艾滋病毒感染者中前列腺癌的发病率显著低于普通人群（SRR，0.6[CI，0.4至0.8]）。只有肛门癌的相对发病率随时间增加。