Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, EPS 7059, Rockville, MD 20892, USA.
JAMA. 2011 Apr 13;305(14):1450-9. doi: 10.1001/jama.2011.396.
Given the higher risk of AIDS-defining malignancies that include Kaposi sarcoma (KS), certain non-Hodgkin lymphomas (NHLs), and cervical cancer in persons with human immunodeficiency virus (HIV) infection, the HIV epidemic has likely contributed to the overall numbers of these cancers in the United States.
To quantify the proportions of KS, AIDS-defining NHLs, and cervical cancer in the United States that occurred among persons with AIDS from 1980 to 2007.
DESIGN, SETTING, AND PARTICIPANTS: The HIV/AIDS Cancer Match Study (1980-2007) linked data from 16 US HIV/AIDS and cancer registries to identify cases with and without AIDS for KS, AIDS-defining NHLs (ie, diffuse large B-cell lymphoma [DLBCL], Burkitt lymphoma [BL], and central nervous system [CNS] lymphoma), and cervical cancer. Using linked data, we derived cancer rates for persons with and without AIDS. To estimate national counts, the rates were applied to national AIDS surveillance and US Census data.
Proportion of AIDS-defining malignancies in the United States occurring in persons with AIDS.
In the United States, an estimated 81.6% (95% confidence interval [CI], 81.2%-81.9%) of 83,252 KS cases, 6.0% (95% CI, 5.8%-6.1%) of 351,618 DLBCL cases, 19.9% (95% CI, 18.1%-21.7%) of 17,307 BL cases, 27.1% (95% CI, 26.1%-28.1%) of 27,265 CNS lymphoma cases, and 0.42% (95% CI, 0.37%-0.47%) of 375,452 cervical cancer cases occurred among persons with AIDS during 1980-2007. The proportion of KS and AIDS-defining NHLs in persons with AIDS peaked in the early 1990s (1990-1995: KS, 90.5% [95% CI, 90.2%-90.8%]; DLBCL, 10.2% [95% CI, 9.9%-10.5%]; BL, 27.8% [95% CI, 25.0%-30.5%]; and CNS lymphoma, 48.3% [95% CI, 46.7%-49.8%]; all P < .001 [compared with 1980-1989]) and then declined (2001-2007: KS, 70.5% [95% CI, 68.1%-73.0%]; DLBCL, 4.7% [95% CI, 4.3%-5.2%]; BL, 21.5% [95% CI, 17.7%-25.4%]; and CNS lymphoma, 12.9% [95% CI, 10.5%-15.3%]; all P < .001 [compared with 1990-1995]). The proportion of cervical cancers in persons with AIDS increased over time (1980-1989: 0.11% [95% CI, 0.09%-0.13%]; 2001-2007: 0.71% [95% CI, 0.51%-0.91%]; P < .001).
In the United States, the estimated proportions of AIDS-defining malignancies that occurred among persons with AIDS were substantial, particularly for KS and some NHLs. Except for cervical cancer, the proportions of AIDS-defining malignancies occurring among persons with AIDS peaked in the mid-1990s and then declined.
由于人类免疫缺陷病毒（HIV）感染者发生艾滋病定义性恶性肿瘤（包括卡波西肉瘤[KS]、某些非霍奇金淋巴瘤[NHL]和宫颈癌）的风险较高，HIV 流行可能导致美国这些癌症的总数增加。
量化 1980 年至 2007 年间美国艾滋病患者中 KS、艾滋病定义性 NHL 和宫颈癌的比例。
设计、地点和参与者：HIV/AIDS 癌症匹配研究（1980-2007 年）将来自 16 个美国 HIV/AIDS 和癌症登记处的数据进行了关联，以确定 KS、艾滋病定义性 NHL（即弥漫性大 B 细胞淋巴瘤[DLBCL]、伯基特淋巴瘤[BL]和中枢神经系统[CNS]淋巴瘤）和宫颈癌患者中有无 AIDS 的病例。利用关联数据，我们得出了有无 AIDS 的人群的癌症发病率。为了估计全国的病例数，将这些发病率应用于全国艾滋病监测和美国人口普查数据。
美国艾滋病患者中发生的艾滋病定义性恶性肿瘤的比例。
在美国，估计有 81.6%（95%置信区间[CI]，81.2%-81.9%）的 83252 例 KS 病例、6.0%（95% CI，5.8%-6.1%）的 351618 例 DLBCL 病例、19.9%（95% CI，18.1%-21.7%）的 17307 例 BL 病例、27.1%（95% CI，26.1%-28.1%）的 27265 例 CNS 淋巴瘤病例和 0.42%（95% CI，0.37%-0.47%）的 375452 例宫颈癌病例发生在艾滋病患者中。艾滋病患者中 KS 和艾滋病定义性 NHL 的比例在 20 世纪 90 年代初达到高峰（1990-1995 年：KS，90.5%[95%CI，90.2%-90.8%]；DLBCL，10.2%[95%CI，9.9%-10.5%]；BL，27.8%[95%CI，25.0%-30.5%]；CNS 淋巴瘤，48.3%[95%CI，46.7%-49.8%]；所有 P<.001[与 1980-1989 年相比]），然后下降（2001-2007 年：KS，70.5%[95%CI，68.1%-73.0%]；DLBCL，4.7%[95%CI，4.3%-5.2%]；BL，21.5%[95%CI，17.7%-25.4%]；CNS 淋巴瘤，12.9%[95%CI，10.5%-15.3%]；所有 P<.001[与 1990-1995 年相比]）。艾滋病患者中宫颈癌的比例随着时间的推移而增加（1980-1989 年：0.11%[95%CI，0.09%-0.13%]；2001-2007 年：0.71%[95%CI，0.51%-0.91%]；P<.001）。
在美国，艾滋病患者中艾滋病定义性恶性肿瘤的估计比例相当大，特别是 KS 和某些 NHL。除宫颈癌外，艾滋病患者中艾滋病定义性恶性肿瘤的比例在 20 世纪 90 年代中期达到高峰，然后下降。
