Highlights of This Issue

Abstract

In the era of effective antiretroviral treatment, HIV-infected individuals experience increased longevity and a higher chronic disease burden. Coghill and colleagues used US surveillance data to model overall mortality in people with HIV and cancer to distinguish whether mortality was simply due to the added individual effects of each disease or higher than expected. For cancers of the lung, breast, colorectum, anus, and Hodgkin and Non-Hodgkin lymphomas, HIV-infected cancer patients experienced excess mortality, beyond that expected based on the effects of HIV and cancer separately. This excess mortality suggests that HIV may contribute to cancer progression and highlights the importance of cancer prevention in this population.Elevated keratinocyte cancer risk has been observed during iatrogenic immunosuppression, but relationships of many immune-related conditions with keratinocyte cancer have not been studied. Yanik and colleagues used Medicare claims to identify 47 immune-related conditions in >1,000,000 keratinocyte cancer cases and corresponding controls. The authors identified elevated keratinocyte cancer risk with solid organ transplantation, non-Hodgkin lymphoma, and numerous other conditions, e.g., granulomatosis with polyangiitis and autoimmune hepatitis. Associations likely result from direct immunosuppressive effects or immunosuppressive treatment. Most conditions were more positively associated with cutaneous squamous cell carcinoma than basal cell carcinoma, indicating a tighter link between immune disturbances and squamous cell carcinoma.In this large population(n = 3,262) of early stage colorectal cancer (CRC), Caan and colleagues demonstrate patients in the overweight range have superior survival because they have adequate muscle mass, an important predictor of better survival, but adiposity levels not high enough to increase risk. Thus, the authors challenge that the observed association between overweight and lower mortality is due to methodological biases alone and provide a biologically compelling explanation for the obesity paradox in CRC. The study demonstrates that the presence of sarcopenia is highly prevalent (42%) among those with non- metastatic CRC, and is likely occult since it occurs across stage and BMI levels.Germline variants associated with breast cancer risk discovered among women of European ancestry may not generalize to other racial/ethnic populations. In this study Feng and colleagues tested 74 breast cancer risk variants and conducted fine-mapping in 6,522 breast cancer cases and 7,643 controls of African ancestry. Seven markers in six regions (3p24, 12p11, 14q13, 16q12/FTO, 16q23, 19p13) were identified to better represent the underlying risk association, whereas signals independent of the index variant were observed in another two regions (11q13, 16q12/TOX3). Epigenomic annotation revealed that many of the risk alleles lie in regions with biological functionality.