Luo Qianlai, Horner Marie-Josèphe, Haas Cameron B, McGee-Avila Jennifer K, Pfeiffer Ruth M, Engels Eric A, Pawlish Karen, Monterosso Analise, Riedel David J, Wu Xiao-Cheng, Gonsalves Lou, Speers Suzanne, Cohen Colby, Shiels Meredith S
National Cancer Institute, Bethesda, MD, USA.
New Jersey State Department of Health, Trenton, NJ, USA.
Clin Infect Dis. 2024 Nov 7. doi: 10.1093/cid/ciae555.
Cancer risk among people with HIV (PWH) has declined over time as a result of antiretroviral therapy, but it is unclear whether all racial/ethnic groups and transmission risk groups have experienced equal declines.
We used data on PWH aged ≥20 years old from the HIV/AIDS Cancer Match Study during 2001-2019. We used Poisson regression to assess time trends in incidence rates for each cancer site by racial/ethnicity and risk group, adjusting for age, registry, and sex. We also estimated adjusted rate ratios across racial and ethnic and risk groups in 2001-2004 and 2015-2019.
Trends in age-standardized rates differed across Black, White and Hispanic PWH, and across risk groups for some cancers. For example, liver cancer rates declined 23% per 5-year period among White PWH, 11% in Black PWH and 18% in Hispanic PWH. Anal cancer rates declined among men who have sex with men, were stable among people who inject drugs, and increased among other risk groups Between 2001-2004 and 2015-2019, relative difference in cancer incidence rates by race/ethnicity increased for HL and liver cancer but decreased for NHL; by risk group, relative differences increased for NHL and liver cancer, and decreased for HL, lung and anal cancers.
Among PWH in the US, during 2001-2019, HL, lung, liver, and cervical cancer rate trends were different across racial/ethnic groups. HL, lung, anal, and liver cancer rates trends were different across risk groups. Future work should examine underlying causes of the differences in trends.
随着抗逆转录病毒疗法的应用,艾滋病毒感染者(PWH)的癌症风险随时间有所下降,但尚不清楚所有种族/族裔群体和传播风险群体的癌症风险下降幅度是否相同。
我们使用了2001 - 2019年期间艾滋病毒/艾滋病癌症匹配研究中年龄≥20岁的艾滋病毒感染者的数据。我们使用泊松回归来评估按种族/族裔和风险组划分的各癌症部位发病率的时间趋势,并对年龄、登记处和性别进行了调整。我们还估计了2001 - 2004年和2015 - 2019年不同种族、族裔和风险组之间的调整率比。
黑人、白人和西班牙裔艾滋病毒感染者以及某些癌症的不同风险组之间,年龄标准化率的趋势有所不同。例如,白人艾滋病毒感染者的肝癌发病率每5年下降23%,黑人艾滋病毒感染者下降11%,西班牙裔艾滋病毒感染者下降18%。男男性行为者的肛管癌发病率下降,注射毒品者的发病率稳定,而其他风险组的发病率上升。在2001 - 2004年和2015 - 2019年期间,霍奇金淋巴瘤(HL)和肝癌按种族/族裔划分的癌症发病率相对差异增加,而非霍奇金淋巴瘤(NHL)则下降;按风险组划分,NHL和肝癌的相对差异增加,HL、肺癌和肛管癌的相对差异下降。
在美国的艾滋病毒感染者中,2001 - 2019年期间,HL、肺癌、肝癌和宫颈癌的发病率趋势在不同种族/族裔群体中存在差异。HL、肺癌、肛管癌和肝癌的发病率趋势在不同风险组中也存在差异。未来的工作应研究这些趋势差异的潜在原因。