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Abstract
BackgroundAlthough increasingly studied in high-income countries, there is a paucity of data from the Chinese population on the patterns of cancer among people living with HIV (PLHIV).MethodsWe conducted a nationwide follow-up study using routinely collected data for adult PLHIV diagnosed on or before 31 December 2011 and alive and in care as of 1 January 2008. Participants were observed from 1 January 2008 (study start) to 30 June 2012 (study end). Main outcome measures were gender-stratified age-standardized incidence rates for China (ASIRC) and standardized incidence ratios (SIR) for all malignancy types/sites observed.ResultsAmong 399,451 subjects, a majority was aged 30–44 years (49.3%), male (69.8%), and Han Chinese (67.9%). A total of 3,819 reports of cancer were identified. Overall, ASIRC was 776.4 per 100,000 for males and 486.5 per 100,000 for females. Malignancy sites/types with highest ASIRC among males were lung (226.0 per 100,000), liver (145.7 per 100,000), and lymphoma (63.1 per 100,000), and among females were lung (66.8 per 100,000), lymphoma (48.0 per 100,000), stomach (47.8 per 100,000), and cervix (47.6 per 100,000). Overall SIR for males was 3.4 and for females was 2.6. Highest SIR was observed for Kaposi sarcoma (2,639.8 for males, 1,593.5 for females) and lymphoma (13.9 for males, 16.0 for females).ConclusionsThese results provide evidence of substantial AIDS-defining and non-AIDS-defining cancer burden among adult Chinese PLHIV between 2008 and 2011. Although further study is warranted, China should take action to improve cancer screening, diagnosis, and treatment for this vulnerable population.
Highlights
Substantial evidence supports a strong link between HIV infection and increased incidence of a broad spectrum of malignancies
Highest standardized incidence ratios (SIR) was observed for Kaposi sarcoma (2,639.8 for males, 1,593.5 for females) and lymphoma (13.9 for males, 16.0 for females)
These results provide evidence of substantial AIDS-defining and non-AIDS-defining cancer burden among adult Chinese people living with HIV (PLHIV) between 2008 and 2011
Summary
Substantial evidence supports a strong link between HIV infection and increased incidence of a broad spectrum of malignancies. Prior to the introduction of antiretroviral therapy (ART) in the mid1990s, incidence of ADCs among people living with HIV (PLHIV) was substantially elevated over that of the general population. Since the widespread scale up of ART, cancer types/sites observed among PLHIV appears to have changed—incidence of KS and NHL has fallen dramatically, while incidence of non-AIDS-defining cancers (NADCs) has risen [2,3,4,5,6,7]. A range of anogenital cancers and head and neck cancers, as well as some non-melanoma skin cancers are associated with the oncogenic subtypes of Human Papillomavirus (HPV). Increasingly studied in high-income countries, there is a paucity of data from the Chinese population on the patterns of cancer among people living with HIV (PLHIV)
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