Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland 20892, USA.
Cancer. 2011 Mar 1;117(5):1089-96. doi: 10.1002/cncr.25547. Epub 2010 Oct 19.
The overall burden of cancer may increase as individuals with acquired immunodeficiency syndrome (AIDS) live longer because of highly active antiretroviral therapy (HAART), which has been widely available since 1996.
A population-based, record-linkage study identified cancers in 472,378 individuals with AIDS from 1980 to 2006. By using nonparametric competing-risk methods, the cumulative incidence of cancer was estimated across 3 calendar periods (AIDS onset in 1980-1989, 1990-1995, and 1996-2006).
Measured at 5 years after AIDS onset, the cumulative incidence of AIDS-defining cancer (ADC) declined sharply across the 3 AIDS calendar periods (from 18% in 1980-1989, to 11% in 1990-1995, to 4.2% in 1996-2006 [ie, the HAART era]). The cumulative incidence of Kaposi sarcoma declined from 14.3% during 1980 to 1989, to 6.7% during 1990 to 1995, and to 1.8% during 1996 to 2006. The cumulative incidence of non-Hodgkin lymphoma (NHL) declined from 3.8% during 1990 through 1995 to 2.2% during 1996 through 2006; during the HAART era, NHL was the most common ADC (53%). The cumulative incidence of non-AIDS-defining cancer (NADC) increased from 1.1% to 1.5% with no change thereafter (1%; 1996-2006), in part because of declines in competing mortality. However, cumulative incidence increased steadily over time for specific NADCs (anal cancer, Hodgkin lymphoma, and liver cancer). The cumulative incidence of lung cancer increased from 0.14% during 1980 to 1989 to 0.32% during 1990 to 1995, and no change was observed thereafter.
Dramatically declining cumulative incidence was noted in 2 major ADCs (Kaposi sarcoma and NHL), and increases were observed in some NADCs (specifically, cancers of the anus, liver, and lung and Hodgkin lymphoma). As HIV/AIDS is increasingly managed as a chronic disease, greater attention should be focused on cancer screening and prevention.
随着高效抗逆转录病毒疗法（HAART）的广泛应用，自 1996 年以来，艾滋病患者的寿命得以延长，因此获得性免疫缺陷综合征（AIDS）患者的整体癌症负担可能会增加。
一项基于人群的记录链接研究在 1980 年至 2006 年间确定了 472378 名 AIDS 患者的癌症。通过使用非参数竞争风险方法，在 3 个日历时期（1980-1989 年、1990-1995 年和 1996-2006 年）估计了癌症的累积发生率。
在 AIDS 发病后 5 年测量时，3 个 AIDS 日历时期的 AIDS 定义性癌症（ADC）累积发生率急剧下降（从 1980-1989 年的 18%下降到 1990-1995 年的 11%，再到 1996-2006 年的 4.2%[即 HAART 时代]）。卡波西肉瘤的累积发病率从 1980 年至 1989 年的 14.3%下降到 1990 年至 1995 年的 6.7%，再到 1996 年至 2006 年的 1.8%。非霍奇金淋巴瘤（NHL）的累积发病率从 1990 年至 1995 年的 3.8%下降到 1996 年至 2006 年的 2.2%；在 HAART 时代，NHL 是最常见的 ADC（53%）。非 AIDS 定义性癌症（NADC）的累积发病率从 1.1%增加到 1.5%，此后没有变化（1%；1996-2006 年），部分原因是竞争死亡率下降。然而，特定 NADCs（肛门癌、霍奇金淋巴瘤和肝癌）的累积发病率随着时间的推移而稳步上升。肺癌的累积发病率从 1980 年至 1989 年的 0.14%上升到 1990 年至 1995 年的 0.32%，此后没有变化。
在 2 种主要的 ADC（卡波西肉瘤和 NHL）中，累积发病率显著下降，而某些 NADCs（特别是肛门、肝脏和肺部癌症以及霍奇金淋巴瘤）的累积发病率则有所上升。随着艾滋病毒/艾滋病越来越被视为一种慢性疾病，应更加关注癌症的筛查和预防。
