Shifts in Cancer Burden for People With HIV Projected

Lower incidence rates of AIDS-defining cancers are likely driven by widespread treatment with modern antiretroviral therapies.
Lower incidence rates of AIDS-defining cancers are likely driven by widespread treatment with modern antiretroviral therapies.

Projections indicate a continued decrease in cancer rate for people living with HIV, particularly AIDS-defining cancers, according to a study presented at the American Association for Cancer Research Annual Meeting 2017.1

"Declines in cancer incidence rates, particularly for AIDS-defining cancers, are likely driven by widespread treatment with modern antiretroviral therapies, which reduce immune suppression and decrease risk of some cancers. Effective treatment also increases the life expectancy of people living with HIV," said Jessica Y. Islam, a doctoral student in Epidemiology at UNC Chapel Hill in North Carolina, in a news release.2

There is a higher risk of certain cancers in people living with HIV, and treatment with highly active antiretroviral therapy (HAART) is associated with improved survival and reduction of risk for some cancers. Also, patients with HIV are living longer placing them at risk for age-associated cancers.  

Islam and colleagues used cancer incidence data during 2000 to 2012 from the HIV/AIDS Cancer Match Study to project the cancer incidence rates in people living with HIV through 2030.

The investigators report that the proportion of the HIV population in the US that will be aged 65 years or older will increase to 21.4% in 2030 from 4.1% in 2006. Furthermore, age-specific rates for non-Hodgkin lymphoma, cervical cancer, and lung cancer are projected to decrease for all age groups. Likewise, rates are projected to decrease for Kaposi sarcoma, Hodgkin lymphoma, and colon cancer for some age groups. Only prostate cancer rates were projected to increase in this group.

The researchers estimate that there will be a decrease in total cancer burden for people living with HIV from 2010 to 2030 (7908 cases to 6495 cases, respectively). This accounts for a dramatic decrease in AIDS defining cancers from 2719 in 2010 to 701 cases in 2030 but a slight increase in non-AIDS defining cancers from 5190 to 5794 cases.

The most common cancers in people living with HIV in 2030 are expected to be prostate, lung, liver, anal cancer, and non-Hodgkin lymphoma.1

"Cancer will continue to be an important comorbidity in this population. Anticipating the types of cancers that are expected to be most common in the future can direct targeted prevention, early detection, and control efforts, including smoking cessation, treatment for hepatitis C and B viruses, age-appropriate cancer screening, and continued widespread treatment with antiretroviral therapy," said co-researcher Meredith S. Shiels, PhD in the news release.2

References

1. Islam JY, Rosenberg PS, Hall HI, et al. Projections of cancer incidence and burden among the HIV-positive population in the United States through 2030. Presented at: American Association for Cancer Research Annual Meeting 2017; April 1-5, 2017; Washington, DC.

2. Cancer burden for aging U.S. HIV population projected to shift [news release]. Chapel Hill, NC: UNC School of Medicine; April 5, 2017. http://unclineberger.org/news/cancer-burden-for-hiv-population. Accessed April 18, 2017.

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