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Trends and risk of lung cancer among people living with HIV in the United States: A population-based registry linkage study
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10 2022
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Source: Lancet HIV. 9(10):e700-e708
[PDF-291.91 KB]
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Alternative Title:Lancet HIV
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Personal Author:
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Description:Background:
Lung cancer is a common cancer in people living with HIV (PLWH). We investigated trends in relative and absolute risk of lung cancer among PLWH within age groups in the United States.
Methods:
We used data from the HIV/AIDS Cancer Match study during 2001–2016. Average annual percentage changes (AAPCs) in lung cancer rates were estimated with multivariable Poisson regression, and standardized incidence ratios (SIRs), and excess absolute risks (EARs) were estimated comparing PLWH to the general US population. We used non-parametric cumulative incidence curves to estimate the 5-year cumulative incidence of lung cancer, and non-Hodgkin lymphoma and Kaposi sarcoma (two AIDS-defining cancers).
Findings:
There were 3,426 lung cancers in 4·3 million person-years of follow-up for PLWH in the U.S. in 2001–2016. Lung cancer rates among PLWH declined 6% per year (95% confidence interval [CI]=−7% to − 5%) during 2001–2016, with greater declines among younger age groups. During 2013–2016, risk of lung cancer among PLWH was 2.0 times higher among 40–49-year-olds (95%CI=1·52–2·61) and 1·3 times higher among 60–69-year-olds (95%CI=1·12–1·52) compared to the general population, while the EARs among PLWH ages 40–49 and 60–69-years-old were 12 (95%CI=4·0–21·9) and 48 (95%CI=6·9–95·5) per 100,000 person-years, respectively. Beginning in 2011, the 5-year cumulative incidence for lung cancer (1·36%) surpassed that of Kaposi sarcoma (0·12%) and non-Hodgkin lymphoma (0·45%) for PLWH aged 60–69 years.
Interpretation:
The risk of lung cancer has decreased for younger PLWH but remains significantly elevated compared to the general population, likely due to a combination of smoking and immunosuppression. For PLWH aged ≥50 years, the risk of lung cancer exceeds that of the most common AIDS-defining cancers, highlighting the importance of lung cancer among the growing older population of PLWH.
Funding:
Intramural Research Program of the National Cancer Institute
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Pubmed ID:36179753
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Pubmed Central ID:PMC9641618
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Volume:9
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Issue:10
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