Abstract
Purpose: We seek to determine whether AA infected with HIV are at a higher risk for developing CRC compared to AA not infected, and to determine whether infected individuals should be screened earlier than the current guidelines suggest. Methods: A temporal database analysis of electronic medical records from the EPIC system (using the EXPLORYS database from 1998 to 2013) covering several medical facilities matching inclusion criteria with a diagnosis of HIV and CRC. Patients were divided into four cohorts including: AA with CRC and HIV, AA without HIV and with CRC, Caucasians with CRC and HIV, and Caucasians without HIV and with CRC. Results: Age of diagnosis of CRC was checked in each group with ages ranging from 40 to 79 years. AA with HIV and CRC totaled 3,150 compared to 20,970 without HIV and with CRC. When age groups were compared there was significance found between ages of 50-54 years (15% with HIV vs. 9% without HIV) and 55-59 years (20% with HIV vs. 13% without HIV). Caucasians with HIV and CRC totaling 1,580 were also compared to Caucasians with CRC and without HIV totaling 142,150. When these age groups were compared there was significance also found between ages of 50-54 years (16% with HIV vs. 10% without HIV) and 55-59 years (19% with HIV vs. 13% without HIV). There was no significance found between race when age and percent of CRC were compared for patients with HIV and without HIV. Relative risk (RR) for patients with HIV developing CRC in AA was 6 and in Caucasians the RR was 2.4. Conclusion: This study suggests that HIV has a profound effect in age of diagnosis and incidence of CRC in both AA and Caucasians. There was greater than a 45% increase in CRC found in the age groups of 50-59 years, the current recommended age for screening. There was no significant difference in incidence of CRC between each race, implying that HIV is the main factor. However, the RR suggests some difference in extent of risk. We recommend HIV be considered a risk factor for early CRC screening with screening occurring at age 40 years.FigureFigure
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