HIV-RELATED MALIGNANCIES: A COMMUNITY BASED STUDY USING A LINKAGE OF CANCER REGISTRY AND HIV REGISTRY DATA

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11 Background: Increased incidence of cancer is documented in immunosuppressed transplant patients. Likewise, as survival increases for persons infected with the Human Immunodeficiency Virus (HIV), we expect their incidence of cancer to increase. This study examined the spectrum of cancer in an HIV infected cohort (especially malignancies not associated with the Acquired Immunodeficiency Syndrome (AIDS)) in relation to the general population. Methods: Cancer incidence data for residents of Harris County, Texas who were diagnosed with a malignancy between 1975 and 1994, was linked to HIV/AIDS registry data by soundex code (coded variable based on name) and birth date, to identify malignancies in an HIV infected cohort of 14,986 persons. There was 100% accuracy in a sample of the linked records, which were verified by the HIV registry staff. A standardized incidence ratio (SIR) analysis was used to compare incidence of cancer in this cohort to that in the general population. Results: In the HIV infected cohort, 2289 persons (15%) were identified as having one or more malignancies. The linkage, alone, identified 29.5% of these malignancies, 28.7% of the malignancies in males and 60.9% of the malignancies in females. HIV infected men and women had incidences of cancer that were 14.1 and 2.6 times that expected for the general population of Harris County, Texas, adjusting for age. Statistically significant SIR's were observed for the AIDS-defining malignancies of Kaposi's sarcoma, non-Hodgkin's lymphoma, primary lymphoma of the brain and cancer of the cervix with SIR's of 203.1, 33.7, 17.9 and 2.5. Statistically significant SIR's were also detected for the malignancies (not AIDS-defining) of other non-melanotic skin cancer, Hodgkin's lymphoma and lung cancer in males (SIR's of 6.5, 5.0 and 0.6) and colon cancer in females (SIR of 4.0). Conclusions: In addition to the malignancies routinely associated with HIV infection, there was a significantly increased risk of being diagnosed with a non-melanotic skin cancer (other than Kaposi's sarcoma) or Hodgkin's lymphoma in males and colon cancer in females. For women, there also appeared to be an increased risk of being diagnosed with Hodgkin's lymphoma, cancer of the larynx and leukemia. The lack of significance, in the latter case, indicated by the confidence intervals, may be due to the small sample size of HIV infected women.