Greenberg Lauren, Ryom Lene, Bakowska Elzbieta, Wit Ferdinand, Bucher Heiner C, Braun Dominique L, Phillips Andrew, Sabin Caroline, d'Arminio Monforte Antonella, Zangerle Robert, Smith Colette, De Wit Stéphane, Bonnet Fabrice, Pradier Christian, Mussini Cristina, Muccini Camilla, Vehreschild Jörg J, Hoy Jennifer, Svedhem Veronica, Miró Jose M, Wasmuth Jan-Christian, Reiss Peter, Llibre Josep M, Chkhartishvili Nikoloz, Stephan Christoph, Hatleberg Camilla I, Neesgaard Bastian, Peters Lars, Jaschinski Nadine, Dedes Nikos, Kuzovatova Elena, Van Der Valk Marc, Menozzi Marianna, Lehmann Clara, Petoumenos Kathy, Garges Harmony, Rooney Jim, Young Lital, Lundgren Jens D, Bansi-Matharu Loveleen, Mocroft Amanda
CHIP, Centre of Excellence for Health, Immunity and Infections Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark.
Department of Infectious Diseases 144, Hvidovre University Hospital, DK-2650 Copenhagen, Denmark.
Cancers (Basel). 2023 Jul 15;15(14):3640. doi: 10.3390/cancers15143640.
Despite cancer being a leading comorbidity amongst individuals with HIV, there are limited data assessing cancer trends across different antiretroviral therapy (ART)-eras. We calculated age-standardised cancer incidence rates (IRs) from 2006-2021 in two international cohort collaborations (D:A:D and RESPOND). Poisson regression was used to assess temporal trends, adjusted for potential confounders. Amongst 64,937 individuals (31% ART-naïve at baseline) and 490,376 total person-years of follow-up (PYFU), there were 3763 incident cancers (IR 7.7/1000 PYFU [95% CI 7.4, 7.9]): 950 AIDS-defining cancers (ADCs), 2813 non-ADCs, 1677 infection-related cancers, 1372 smoking-related cancers, and 719 BMI-related cancers (groups were not mutually exclusive). Age-standardised IRs for overall cancer remained fairly constant over time (8.22/1000 PYFU [7.52, 8.97] in 2006-2007, 7.54 [6.59, 8.59] in 2020-2021). The incidence of ADCs (3.23 [2.79, 3.72], 0.99 [0.67, 1.42]) and infection-related cancers (4.83 [4.2, 5.41], 2.43 [1.90, 3.05]) decreased over time, whilst the incidence of non-ADCs (4.99 [4.44, 5.58], 6.55 [5.67, 7.53]), smoking-related cancers (2.38 [2.01, 2.79], 3.25 [2.63-3.96]), and BMI-related cancers (1.07 [0.83, 1.37], 1.88 [1.42, 2.44]) increased. Trends were similar after adjusting for demographics, comorbidities, HIV-related factors, and ART use. These results highlight the need for better prevention strategies to reduce the incidence of NADCs, smoking-, and BMI-related cancers.
尽管癌症是艾滋病毒感染者中一种主要的合并症，但评估不同抗逆转录病毒疗法（ART）时代癌症趋势的数据有限。我们在两项国际队列合作研究（D:A:D和RESPOND）中计算了2006年至2021年的年龄标准化癌症发病率（IR）。采用泊松回归评估时间趋势，并对潜在混杂因素进行了调整。在64937名个体（基线时31%为未接受ART治疗者）和总计490376人年的随访（PYFU）中，有3763例新发癌症（IR为7.7/1000 PYFU [95%CI 7.4, 7.9]）：950例艾滋病定义的癌症（ADC）、2813例非ADC、1677例感染相关癌症、1372例吸烟相关癌症和719例BMI相关癌症（各组并非相互排斥）。总体癌症的年龄标准化发病率随时间保持相对稳定（2006 - 2007年为8.22/1000 PYFU [7.52, 8.97]，2020 - 2021年为7.54 [6.59, 8.59]）。ADC（3.23 [2.79, 3.72]，0.99 [0.67, 1.42]）和感染相关癌症（4.83 [4.2, 5.41]，2.43 [1.90, 3.05]）的发病率随时间下降，而非ADC（4.99 [4.44, 5.58]，6.55 [5.67, 7.53]）、吸烟相关癌症（2.38 [2.01, 2.79]，3.25 [2.63 - 3.96]）和BMI相关癌症（1.07 [0.83, 1.37]，1.88 [1.42, 2.44]）的发病率上升。在对人口统计学、合并症、艾滋病毒相关因素和ART使用情况进行调整后，趋势相似。这些结果凸显了需要更好的预防策略来降低非ADC、吸烟和BMI相关癌症的发病率。
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