Aix-Marseille Univ, APHM Sainte-Marguerite, Clinical Immuno-Hematological Unit Marseille, Marseille, France.
Aix-Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France.
PLoS One. 2022 Mar 25;17(3):e0261069. doi: 10.1371/journal.pone.0261069. eCollection 2022.
We aimed to evaluate the incidence rates between 2010 and 2015 for invasive cervical cancer (ICC), breast cancer (BC), and colorectal cancer (CRC) in people living with HIV (PLWH) in France, and to compare them with those in the French general population. These cancers are targeted by the national cancer-screening program.
This is a retrospective study based on the longitudinal data of the French Dat'AIDS cohort.
Standardized incidence ratios (SIR) for ICC and BC, and incidence rates for all three cancers were calculated overall and for specific sub-populations according to nadir CD4 cell count, HIV transmission category, HIV diagnosis period, and HCV coinfection.
The 2010-2015 CRC incidence rate was 25.0 [95% confidence interval (CI): 18.6-33.4] per 100,000 person-years, in 44,642 PLWH (both men and women). Compared with the general population, the ICC incidence rate was significantly higher in HIV-infected women both overall (SIR = 1.93, 95% CI: 1.18-3.14) and in the following sub-populations: nadir CD4 ≤ 200 cells/mm3 (SIR = 2.62, 95% CI: 1.45-4.74), HIV transmission through intravenous drug use (SIR = 5.14, 95% CI: 1.93-13.70), HCV coinfection (SIR = 3.52, 95% CI: 1.47-8.47) and HIV diagnosis before 2000 (SIR = 2.06, 95% CI: 1.07-3.97). Conversely, the BC incidence rate was significantly lower in the study sample than in the general population (SIR = 0.56, 95% CI: 0.42-0.73).
The present study showed no significant linear trend between 2010 and 2015 in the incidence rates of the three cancers explored in the PLWH study sample. Specific recommendations for ICC screening are still required for HIV-infected women and should focus on sub-populations at greatest risk.
本研究旨在评估 2010 年至 2015 年期间法国艾滋病毒感染者（PLWH）中浸润性宫颈癌（ICC）、乳腺癌（BC）和结直肠癌（CRC）的发病率，并与法国普通人群进行比较。这些癌症是国家癌症筛查计划的目标。
这是一项基于法国 Dat'AIDS 队列纵向数据的回顾性研究。
根据 CD4 细胞计数最低值、HIV 传播途径、HIV 诊断时期和 HCV 合并感染，计算 ICC 和 BC 的标准化发病比（SIR），以及所有三种癌症的发病率。
2010 年至 2015 年期间，44642 名 PLWH（男女性别均有）中 CRC 的发病率为 25.0 [95%置信区间（CI）：18.6-33.4] /10 万人口年。与普通人群相比，HIV 感染女性的 ICC 发病率总体较高（SIR = 1.93，95%CI：1.18-3.14），且在以下亚人群中更高：CD4 细胞计数最低值≤200 个/mm3（SIR = 2.62，95%CI：1.45-4.74）、静脉吸毒传播（SIR = 5.14，95%CI：1.93-13.70）、HCV 合并感染（SIR = 3.52，95%CI：1.47-8.47）和 2000 年前诊断 HIV（SIR = 2.06，95%CI：1.07-3.97）。相反，研究样本中的 BC 发病率明显低于普通人群（SIR = 0.56，95%CI：0.42-0.73）。
本研究显示，在 PLWH 研究样本中，2010 年至 2015 年期间三种癌症的发病率没有明显的线性趋势。仍需针对 HIV 感染女性制定 ICC 筛查的具体建议，且应重点关注高危亚人群。
