Excess Mortality among HIV-infected Individuals with Cancer in the United States

Details

• Alternative Title:
  Cancer Epidemiol Biomarkers Prev
• Personal Author:
  Coghill, Anna E. ; Pfeiffer, Ruth M. ; Shiels, Meredith S. ; Engels, Eric A.
• Description:
  Background
  
  HIV-infected persons are living longer in the era of effective HIV treatment, resulting in an increasing cancer burden in this population. The combined effects of HIV and cancer on mortality are incompletely understood.
  
  Methods
  
  We examined whether individuals with both HIV and cancer have excess mortality using data from the HIV/AIDS Cancer Match Study and the National Center for Health Statistics (1996–2010). We compared age, sex, and race-stratified mortality between people with and without HIV or one of the following cancers: lung, breast, prostate, colorectum, anus, Hodgkin lymphoma, or non-Hodgkin lymphoma. We utilized additive Poisson regression models that included terms for HIV, cancer, and an interaction for their combined effect on mortality. We report the number of excess deaths per 1,000 person-years for models with a significant interaction (P<0.05).
  
  Results
  
  For all cancers examined except prostate cancer, at least one demographic subgroup of HIV-infected cancer patients experienced significant excess mortality. Excess mortality was most pronounced at younger ages (30–49 years), with large excesses for males with lung cancer (white race:573 per 1,000 person-years; non-white:503) and non-Hodgkin lymphoma (white:236; non-white:261), and for females with Hodgkin lymphoma (white:216; non-white:136) and breast cancer (non-white:107).
  
  Conclusion
  
  In the era of effective HIV treatment, overall mortality in patients with both HIV and cancer was significantly higher than expected based on mortality rates for each disease separately.
  
  Impact
  
  These results suggest that HIV may contribute to cancer progression and highlight the importance of improved cancer prevention and care for the US HIV population.
  
  
• Subjects:
  Adult Aged Aged, 80 And Over Age Factors Article Comorbidity Female HIV And Cancer Burden HIV And Cancer Mortality HIV Infections Humans Male Middle Aged Mortality Neoplasms Non-AIDS-defining Malignancies Risk Factors

  More +
• Source:
  Cancer Epidemiol Biomarkers Prev. 26(7):1027-1033.
• Pubmed ID:
  28619832
• Pubmed Central ID:
  PMC5500417
• Document Type:
  Journal Article
• Funding:
  U58 DP003931/DP/NCCDPHP CDC HHS/United States ; U62 PS004011/PS/NCHHSTP CDC HHS/United States ; Z99 CA999999/NULL/Intramural NIH HHS/United States ; U58 DP003875/DP/NCCDPHP CDC HHS/United States ; HHSN261201300021C/CA/NCI NIH HHS/United States ; U58 DP000848/DP/NCCDPHP CDC HHS/United States ; U58 DP000812/DP/NCCDPHP CDC HHS/United States ; HHSN261201000024C/CA/NCI NIH HHS/United States ; U62 PS001005/PS/NCHHSTP CDC HHS/United States ; U62 PS004001/PS/NCHHSTP CDC HHS/United States ; U58 DP000824/DP/NCCDPHP CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  26
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:43d45f847c5f80bcbfdfe6a33b38c5563d496d9b0af774e5ba2064b0d1d252e5
• Download URL:
  https://stacks.cdc.gov/view/cdc/56258/cdc_56258_DS1.pdf
• File Type:
  [PDF - 439.66 KB ]