Sengayi Mazvita, Spoerri Adrian, Egger Matthias, Kielkowski Danuta, Crankshaw Tamaryn, Cloete Christie, Giddy Janet, Bohlius Julia
National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa.
Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland.
Int J Cancer. 2016 Sep 15;139(6):1209-16. doi: 10.1002/ijc.30154. Epub 2016 May 18.
The surveillance of HIV-related cancers in South Africa is hampered by the lack of systematic collection of cancer diagnoses in HIV cohorts and the absence of HIV status in cancer registries. To improve cancer ascertainment and estimate cancer incidence, we linked records of adults (aged ≥ 16 years) on antiretroviral treatment (ART) enrolled at Sinikithemba HIV clinic, McCord Hospital in KwaZulu-Natal (KZN) with the cancer records of public laboratories in KZN province using probabilistic record linkage (PRL) methods. We calculated incidence rates for all cancers, Kaposi sarcoma (KS), cervix, non-Hodgkin's lymphoma and non-AIDS defining cancers (NADCs) before and after inclusion of linkage-identified cancers with 95% confidence intervals (CIs). A total of 8,721 records of HIV-positive patients were linked with 35,536 cancer records. Between 2004 and 2010, we identified 448 cancers, 82% (n = 367) were recorded in the cancer registry only, 10% (n = 43) in the HIV cohort only and 8% (n = 38) both in the HIV cohort and the cancer registry. The overall cancer incidence rate in patients starting ART increased from 134 (95% CI 91-212) to 877 (95% CI 744-1,041) per 100,000 person-years after inclusion of linkage-identified cancers. Incidence rates were highest for KS (432, 95% CI 341-555), followed by cervix (259, 95% CI 179-390) and NADCs (294, 95% CI 223-395) per 100,000 person-years. Ascertainment of cancer in HIV cohorts is incomplete, PRL is both feasible and essential for cancer ascertainment.
南非缺乏对艾滋病毒感染者队列中的癌症诊断进行系统收集，且癌症登记处没有艾滋病毒感染状况信息，这妨碍了对与艾滋病毒相关癌症的监测。为了改善癌症确诊情况并估计癌症发病率，我们使用概率性记录链接（PRL）方法，将夸祖鲁 - 纳塔尔省（KZN）麦考德医院西尼基滕巴艾滋病毒诊所登记接受抗逆转录病毒治疗（ART）的成年人（年龄≥16岁）记录与KZN省公共实验室的癌症记录相链接。我们计算了纳入链接识别出的癌症前后所有癌症、卡波西肉瘤（KS）、子宫颈癌、非霍奇金淋巴瘤和非艾滋病定义癌症（NADC）的发病率，并给出95%置信区间（CI）。总共8721份艾滋病毒阳性患者记录与35536份癌症记录相链接。在2004年至2010年期间，我们识别出448例癌症，其中82%（n = 367）仅记录在癌症登记处，10%（n = 43）仅记录在艾滋病毒感染者队列中，8%（n = 38）既记录在艾滋病毒感染者队列中也记录在癌症登记处。纳入链接识别出的癌症后，开始接受ART治疗患者的总体癌症发病率从每10万人年134例（95%CI 91 - 212）增至877例（95%CI 744 - 1041）。每10万人年发病率最高的是KS（432例，95%CI 341 - 555），其次是子宫颈癌（259例，95%CI 179 - 390）和NADC（294例，95%CI 223 - 395）。艾滋病毒感染者队列中的癌症确诊情况不完整，PRL对于癌症确诊既可行又至关重要。
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