Cancer in children and adolescents with AIDS in the city of São Paulo: A population-based linkage study

Abstract

Introduction Previous studies revealed an elevated risk of cancer in children and adolescents with AIDS. However, there is limited population-based data from developing countries. The objective of the present study was to describe the cancer spectrum in children and adolescents with AIDS in the City of Sao Paulo from 1997 to 2012. Methods It is a population-based registry linkage study using the databases of the Population-based Cancer Registry of Sao Paulo (1997–2012) and of the Sistema de Informacao de Agravos de Notificacao (SINAN)/Information System on Disease Notification (1984–2013). Children and adolescents with AIDS and cancer have been identified by means of a probabilistic record linkage process between the aforementioned databases. We calculated crude and age-standardized incidence rates (world standard population, 0–19 years) per million. To assess trends, we calculated the annual percent change (APC) and its 95% confidence intervals (95% CI) using Joinpoint software. To compare risk of cancer in children with AIDS to that of the general pediatric population of Sao Paulo, we estimated the standardized incidence ratio (SIR) and respective 95% CIs. Analysis were stratified by AIDS-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs). Results We identified 24 cases of cancer in patients with AIDS aged Conclusion To our knowledge, this is the first population-based study to describe cancer spectrum in children and adolescents with AIDS in Brazil. ADCs still account for an important share of cancer cases in this pediatric population. Between 1997 and 2012, there has been a reduction in the incidence of all cancers, driven by the decrease in the incidence of ADCs because of wide use of antiretroviral therapy. The finding of the present study is in line with previous research conducted in the United States, Spain and Italy. However, children and adolescents with AIDS remain at increased risk for developing ADCs as well as HL in comparison to the general population.