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Open Access Research article

Recent cancer incidence trends in an observational clinical cohort of HIV-infected patients in the US, 2000 to 2011

Elizabeth L Yanik1, Kristen Tamburro2, Joseph J Eron3, Blossom Damania4, Sonia Napravnik5 and Dirk P Dittmer2*

Author Affiliations

1 Department of Epidemiology, University of North Carolina at Chapel Hill, 130 Mason Farm Rd, Chapel Hill, NC, USA

2 Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, 715 Mary Ellen Jones Building, Chapel Hill, NC, USA

3 Division of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Rd, Chapel Hill, NC, USA

4 Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, 31–353 Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA

5 Division of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Rd, Chapel Hill, NC, USA

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Infectious Agents and Cancer 2013, 8:18  doi:10.1186/1750-9378-8-18

Published: 24 May 2013

Abstract

Background

In HIV-infected populations in developed countries, the most recent published cancer incidence trend analyses are only updated through 2008. We assessed changes in the distribution of cancer types and incidence trends among HIV-infected patients in North Carolina up until 2011.

Methods

We linked the University of North Carolina Center for AIDS Research HIV Clinical Cohort, an observational clinical cohort of 3141 HIV-infected patients, with the North Carolina Cancer registry. Cancer incidence rates were estimated across calendar years from 2000 to 2011. The distribution of cancer types was described. Incidence trends were assessed with linear regression.

Results

Across 15,022 person-years of follow-up, 202 cancers were identified (incidence rate per 100,000 person-years [IR]: 1345; 95% confidence interval [CI]: 1166, 1544). The majority of cancers were virus-related (61%), including Kaposi sarcoma (N = 32) (IR: 213; 95%CI: 146, 301), non-Hodgkin lymphoma (N = 34) (IR: 226; 95%CI: 157, 316), and anal cancer (N = 16) (IR: 107; 95%CI: 61, 173). Non-Hodgkin lymphoma was observed to decrease from 2000 to 2011 (decline of 15 cases per 100,000 person-years per calendar year, 95%CI: -27, -3). No other changes in incidence or changes in incidence trends were observed for other cancers (all P > 0.20).

Conclusions

We observed a substantial burden of a variety of cancers in this population in the last decade. Kaposi sarcoma and non-Hodgkin lymphoma were consistently two of the greatest contributors to cancer burden across calendar time. Cancer rates appeared stable across calendar years, except for non-Hodgkin lymphoma, which appeared to decrease throughout the study period.

Keywords:
Kaposi sarcoma; AIDS; HIV; AIDS-associated malignancies; Cancer