预计到 2030 年，美国艾滋病毒感染者中癌症发病率和新发病例负担。
Projected Cancer Incidence Rates and Burden of Incident Cancer Cases in HIV-Infected Adults in the United States Through 2030.
机构信息
National Cancer Institute, Rockville, Maryland (M.S.S., P.S.R., E.A.E.).
National Cancer Institute, Rockville, Maryland, and University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina (J.Y.I.).
出版信息
Ann Intern Med. 2018 Jun 19;168(12):866-873. doi: 10.7326/M17-2499. Epub 2018 May 8.
BACKGROUND
Persons living with HIV (PLWH) have an elevated risk for certain types of cancer. With modern antiretroviral therapy, PLWH are aging and cancer rates are changing.
OBJECTIVE
To project cancer incidence rates and burden (number of new cancer diagnoses) among adult PLWH in the United States through 2030.
DESIGN
Descriptive.
SETTING
HIV/AIDS Cancer Match Study to project cancer rates and HIV Optimization and Prevention Economics model to project HIV prevalence.
PARTICIPANTS
HIV-infected adults.
MEASUREMENTS
Projected cancer rates and burden among HIV-infected adults in the United States by age during 2006 to 2030 for AIDS-defining cancer (ADC)-that is, Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer-and certain types of non-AIDS-defining cancer (NADC). All other cancer types were combined.
RESULTS
The proportion of adult PLWH in the United States aged 65 years or older is projected to increase from 8.5% in 2010 to 21.4% in 2030. Age-specific rates are projected to decrease through 2030 across age groups for Kaposi sarcoma, non-Hodgkin lymphoma, cervical cancer, lung cancer, Hodgkin lymphoma, and other cancer types combined, and among those aged 65 years or older for colon cancer. Prostate cancer rates are projected to increase. The estimated total cancer burden in PLWH will decrease from 8150 cases in 2010 (2730 of ADC and 5420 of NADC) to 6690 cases in 2030 (720 of ADC and 5980 of NADC). In 2030, prostate cancer (n = 1590) and lung cancer (n = 1030) are projected to be the most common cancer types.
LIMITATION
Projections assume that current trends in cancer incidence rates, HIV transmission, and survival will continue.
CONCLUSION
The cancer burden among PLWH is projected to shift, with prostate and lung cancer expected to emerge as the most common types by 2030. Cancer will remain an important comorbid condition, and expanded access to HIV therapies and cancer prevention, screening, and treatment is needed.
PRIMARY FUNDING SOURCE
National Cancer Institute.
背景
HIV 感染者（PLWH）患某些类型癌症的风险较高。随着现代抗逆转录病毒疗法的应用，PLWH 正在老龄化，癌症发病率也在发生变化。
目的
通过 2030 年预测美国成年 PLWH 的癌症发病率和负担（新癌症诊断数量）。
设计
描述性研究。
设置
HIV/AIDS 癌症匹配研究用于预测癌症发病率，HIV 优化和预防经济学模型用于预测 HIV 流行率。
参与者
HIV 感染者。
测量
通过 2006 年至 2030 年，根据年龄预测美国 HIV 感染者中 AIDS 定义性癌症（ADC）——即卡波西肉瘤、非霍奇金淋巴瘤和宫颈癌——和某些非 AIDS 定义性癌症（NADC）的癌症发病率和负担。所有其他癌症类型都合并在一起。
结果
预计美国 65 岁及以上成年 PLWH 的比例将从 2010 年的 8.5%增加到 2030 年的 21.4%。预计 Kaposi 肉瘤、非霍奇金淋巴瘤、宫颈癌、肺癌、霍奇金淋巴瘤和其他所有癌症类型的年龄特异性发病率将在 2030 年前在各年龄段中下降，65 岁及以上年龄组的结肠癌发病率也将下降。前列腺癌的发病率预计将增加。PLWH 的估计癌症总负担将从 2010 年的 8150 例（ADC 为 2730 例，NADC 为 5420 例）减少到 2030 年的 6690 例（ADC 为 720 例，NADC 为 5980 例）。预计 2030 年最常见的癌症类型将是前列腺癌（n=1590）和肺癌（n=1030）。
局限性
预测假设癌症发病率、HIV 传播和生存率的当前趋势将继续。
结论
PLWH 的癌症负担预计将发生转变，预计到 2030 年前列腺癌和肺癌将成为最常见的癌症类型。癌症仍将是一种重要的合并症，需要扩大获得 HIV 治疗和癌症预防、筛查和治疗的机会。
主要资金来源
美国国家癌症研究所。
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