Skip to main content
Top
Published in: BMC Cancer 1/2015

Open Access 01-12-2015 | Research article

Risk of cancer among HIV-infected patients from a population-based nested case–control study: implications for cancer prevention

Authors: Chang-Hua Chen, Chih-Yuan Chung, Li-Hsuan Wang, Che Lin, Hsiu-Li Lin, Hsiu-Chen Lin

Published in: BMC Cancer | Issue 1/2015

Login to get access

Abstract

Background

The burden of cancer is likely to increase among the human immunodeficiency virus (HIV)-positive population as it ages due to successful antiretroviral therapy (ART). The purpose of this study was to determine the risk of cancer in HIV-infected patients.

Methods

This study was a matched nested case–control study. It was performed using the National Health Insurance Research Database of Taiwan. The control group included non–HIV-infected patients matched by sex, age, and year of enrollment. Logistic regression analyses were performed and simultaneously adjusted for potential confounders (income, urbanization, and Charslon index of comorbidity to evaluate HIV infection as an independent risk of cancer. We calculated the overall and sex-specific standardized incidence ratios (SIR) to investigate the pattern of cancer risk and overall cancer risk in the patients with HIV infection.

Results

Of the 1,115 HIV-infected patients, 104 (9.33%) developed cancer during the 11-year follow-up period. The risk of cancer for patients with HIV infection was significant (adjusted odds ratio = 3.89, 95% confidence interval [CI] = 2.92–5.19) after adjustment for potential confounders. There was a significantly increased risk of developing non-Hodgkin lymphoma (SIR = 25.73, 95% CI = 6.83-90.85), cervical cancer (SIR = 4.01, 95% CI = 1.0-16.06), lymphoma (SIR = 20.26, 95% CI = 5.86-70.10), and respiratory and intrathoracic cancer (SIR = 20.09, 95% CI = 2.34-172.09) compared with the control group. In addition, HIV-infected patients were at significant risk for renal, oral, breast, liver, skin, and colorectal cancer.

Conclusions

Patients with HIV infection are at increased risk for several specific cancers. Our results support the implementation of an active and accelerated cancer screening schedule for patients with HIV infection to increase their life span.
Literature
1.
go back to reference Gotti D, Raffetti E, Albini L, Sighinolfi L, Maggiolo F, Di Filippo E, et al. Survival in HIV-infected patients after a cancer diagnosis in the cART Era: results of an Italian multicenter study. PLoS One. 2014;9:e94768.CrossRefPubMedPubMedCentral Gotti D, Raffetti E, Albini L, Sighinolfi L, Maggiolo F, Di Filippo E, et al. Survival in HIV-infected patients after a cancer diagnosis in the cART Era: results of an Italian multicenter study. PLoS One. 2014;9:e94768.CrossRefPubMedPubMedCentral
2.
go back to reference Hymes KB, Cheung T, Greene JB, Prose NS, Marcus A, Ballard H, et al. Kaposi’s sarcoma in homosexual men-a report of eight cases. Lancet. 1981;8:598–600.CrossRef Hymes KB, Cheung T, Greene JB, Prose NS, Marcus A, Ballard H, et al. Kaposi’s sarcoma in homosexual men-a report of eight cases. Lancet. 1981;8:598–600.CrossRef
3.
go back to reference Curran JW, Jaffe HW. AIDS: the early years and CDC’s response. MMWR Surveill Summ. 2011;8:64–9. Curran JW, Jaffe HW. AIDS: the early years and CDC’s response. MMWR Surveill Summ. 2011;8:64–9.
4.
go back to reference Bouvard V, Baan R, Straif K, Grosse Y, Secretan B, El Ghissassi F, et al. WHO International Agency for Research on Cancer Monograph Working Group: A review of human carcinogens–Part B: biological agents. Lancet Oncol. 2009;8:321–2.CrossRef Bouvard V, Baan R, Straif K, Grosse Y, Secretan B, El Ghissassi F, et al. WHO International Agency for Research on Cancer Monograph Working Group: A review of human carcinogens–Part B: biological agents. Lancet Oncol. 2009;8:321–2.CrossRef
5.
go back to reference Detels R, Muñoz A, McFarlane G, Kingsley LA, Margolick JB, Giorgi J, et al. Effectiveness of potent antiretroviral therapy on time to AIDS and death in men with known HIV infection duration. Multicenter AIDS Cohort Study Investigators. JAMA. 1998;280:497–503.CrossRef Detels R, Muñoz A, McFarlane G, Kingsley LA, Margolick JB, Giorgi J, et al. Effectiveness of potent antiretroviral therapy on time to AIDS and death in men with known HIV infection duration. Multicenter AIDS Cohort Study Investigators. JAMA. 1998;280:497–503.CrossRef
6.
go back to reference Smith CJ, Ryom L, Weber R, Morlat P, Pradier C, Reiss P, et al. Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration. Lancet. 2014;384:241–8.CrossRefPubMed Smith CJ, Ryom L, Weber R, Morlat P, Pradier C, Reiss P, et al. Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration. Lancet. 2014;384:241–8.CrossRefPubMed
7.
go back to reference Liu CY, Hung YT, Chuang YL, Chen YJ, Weng WS, Liu JS, et al. Incorporating development stratification of Taiwan townships into sampling design of large scale health interview survey. J Health Manag. 2006;4:1–22. Liu CY, Hung YT, Chuang YL, Chen YJ, Weng WS, Liu JS, et al. Incorporating development stratification of Taiwan townships into sampling design of large scale health interview survey. J Health Manag. 2006;4:1–22.
8.
go back to reference Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.CrossRefPubMed Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.CrossRefPubMed
9.
go back to reference Cooley TP. Non–AIDS-defining cancer in HIV-infected people. Hematol Oncol Clin North Am. 2003;17:889–99.CrossRefPubMed Cooley TP. Non–AIDS-defining cancer in HIV-infected people. Hematol Oncol Clin North Am. 2003;17:889–99.CrossRefPubMed
10.
go back to reference Intra M, Gentilini O, Brenelli F, Chagas EM, Veronesi U, Sandri MT. Breast cancer among HIV infected patients: the experience of the European Institute of Oncology. J Surg Oncol. 2005;91:141–2.CrossRefPubMed Intra M, Gentilini O, Brenelli F, Chagas EM, Veronesi U, Sandri MT. Breast cancer among HIV infected patients: the experience of the European Institute of Oncology. J Surg Oncol. 2005;91:141–2.CrossRefPubMed
11.
go back to reference Goedert JJ, Schairer C, McNeel TS, Hessol NA, Rabkin CS, Engels EA; HIV/AIDS Cancer Match Study. HIV/AIDS Cancer Match Study, Risk of breast, ovary, and uterine corpus cancers among 85,268 women with AIDS. Br J Cancer. 2006;95:642–8.CrossRefPubMedPubMedCentral Goedert JJ, Schairer C, McNeel TS, Hessol NA, Rabkin CS, Engels EA; HIV/AIDS Cancer Match Study. HIV/AIDS Cancer Match Study, Risk of breast, ovary, and uterine corpus cancers among 85,268 women with AIDS. Br J Cancer. 2006;95:642–8.CrossRefPubMedPubMedCentral
12.
go back to reference Shiels MS, Cole SR, Kirk GD, Poole C. A meta-analysis of the incidence of non-AIDS cancers in HIV-infected individuals. J Acquir Immune Defic Syndr. 2009;52:611–22.CrossRefPubMedPubMedCentral Shiels MS, Cole SR, Kirk GD, Poole C. A meta-analysis of the incidence of non-AIDS cancers in HIV-infected individuals. J Acquir Immune Defic Syndr. 2009;52:611–22.CrossRefPubMedPubMedCentral
13.
go back to reference Sigel K, Dubrow R, Silverberg M, Crothers K, Braithwaite S, Justice A. Cancer screening in patients infected with HIV. Curr HIV/AIDS Rep. 2011;8:142–52.CrossRefPubMedPubMedCentral Sigel K, Dubrow R, Silverberg M, Crothers K, Braithwaite S, Justice A. Cancer screening in patients infected with HIV. Curr HIV/AIDS Rep. 2011;8:142–52.CrossRefPubMedPubMedCentral
15.
16.
go back to reference Vogel M, Friedrich O, Lüchters G, Holleczek B, Wasmuth JC, Anadol E, et al. Cancer risk in HIV-infected individuals on HAART is largely attributed to oncogenic infections and state of immunocompetence. Eur J Med Res. 2011;16:101–7.CrossRefPubMedPubMedCentral Vogel M, Friedrich O, Lüchters G, Holleczek B, Wasmuth JC, Anadol E, et al. Cancer risk in HIV-infected individuals on HAART is largely attributed to oncogenic infections and state of immunocompetence. Eur J Med Res. 2011;16:101–7.CrossRefPubMedPubMedCentral
17.
go back to reference Biggar RJ, Chaturvedi AK, Goedert JJ, Engels EA; HIV/AIDS Cancer Match Study. AIDS-related cancer and severity of immunosuppression in persons with AIDS. J Natl Cancer Inst. 2007;99:962–72.CrossRefPubMed Biggar RJ, Chaturvedi AK, Goedert JJ, Engels EA; HIV/AIDS Cancer Match Study. AIDS-related cancer and severity of immunosuppression in persons with AIDS. J Natl Cancer Inst. 2007;99:962–72.CrossRefPubMed
18.
go back to reference Lin CH, Liau JY, Lu YS, Huang CS, Lee WC, Kuo KT, et al. Molecular subtypes of breast cancer emerging in young women in Taiwan: evidence for more than just westernization as a reason for the disease in Asia. Cancer Epidemiol Biomarkers Prev. 2009;18:1807–14.CrossRefPubMed Lin CH, Liau JY, Lu YS, Huang CS, Lee WC, Kuo KT, et al. Molecular subtypes of breast cancer emerging in young women in Taiwan: evidence for more than just westernization as a reason for the disease in Asia. Cancer Epidemiol Biomarkers Prev. 2009;18:1807–14.CrossRefPubMed
20.
go back to reference Lin C, Chien SY, Chen LS, Kuo SJ, Chang TW, Chen DR. Triple negative breast carcinoma is a prognostic factor in Taiwanese women. BMC Cancer. 2009;9:192.CrossRefPubMedPubMedCentral Lin C, Chien SY, Chen LS, Kuo SJ, Chang TW, Chen DR. Triple negative breast carcinoma is a prognostic factor in Taiwanese women. BMC Cancer. 2009;9:192.CrossRefPubMedPubMedCentral
21.
go back to reference Grulich AE, Li Y, McDonald AM, Correll PK, Law MG, Kaldor JM. Decreasing rates of Kaposi’s sarcoma and non-Hodgkin’s lymphoma in the era of potent combination anti-retroviral therapy. AIDS. 2001;15:629–33.CrossRefPubMed Grulich AE, Li Y, McDonald AM, Correll PK, Law MG, Kaldor JM. Decreasing rates of Kaposi’s sarcoma and non-Hodgkin’s lymphoma in the era of potent combination anti-retroviral therapy. AIDS. 2001;15:629–33.CrossRefPubMed
22.
go back to reference Crum-Cianflone N, Hullsiek KH, Satter E, Marconi V, Weintrob A, Ganesan A, et al. Cutaneous malignancies among HIV-infected persons. Arch Intern Med. 2009;169:1130–8.CrossRefPubMedPubMedCentral Crum-Cianflone N, Hullsiek KH, Satter E, Marconi V, Weintrob A, Ganesan A, et al. Cutaneous malignancies among HIV-infected persons. Arch Intern Med. 2009;169:1130–8.CrossRefPubMedPubMedCentral
23.
24.
go back to reference Shiels MS, Pfeiffer RM, Gail MH, Hall HI, Li J, Chaturvedi AK, et al. Cancer burden in the HIV-infected population in the United States. J Natl Cancer Inst. 2011;103:753–62.CrossRefPubMedPubMedCentral Shiels MS, Pfeiffer RM, Gail MH, Hall HI, Li J, Chaturvedi AK, et al. Cancer burden in the HIV-infected population in the United States. J Natl Cancer Inst. 2011;103:753–62.CrossRefPubMedPubMedCentral
25.
go back to reference Mani D, Haigentz Jr M, Aboulafia DM. Lung cancer in HIV infection. Clin Lung Cancer. 2012;13:6–13.CrossRefPubMed Mani D, Haigentz Jr M, Aboulafia DM. Lung cancer in HIV infection. Clin Lung Cancer. 2012;13:6–13.CrossRefPubMed
26.
go back to reference Clifford GM, Lise M, Franceschi S, Egger M, Bouchardy C, Korol D, et al. Lung cancer in the Swiss HIV Cohort Study: role of smoking, immunodeficiency and pulmonary infection. Br J Cancer. 2012;106:447–52.CrossRefPubMedPubMedCentral Clifford GM, Lise M, Franceschi S, Egger M, Bouchardy C, Korol D, et al. Lung cancer in the Swiss HIV Cohort Study: role of smoking, immunodeficiency and pulmonary infection. Br J Cancer. 2012;106:447–52.CrossRefPubMedPubMedCentral
27.
go back to reference Bureau of Health Promotion, D.O.H., Taiwan, ROC. Cancer Registry Annual Report, 1995–2008. Taipei: Department of Health, Executive Yuan, Taiwan, ROC; 2010. Bureau of Health Promotion, D.O.H., Taiwan, ROC. Cancer Registry Annual Report, 1995–2008. Taipei: Department of Health, Executive Yuan, Taiwan, ROC; 2010.
28.
go back to reference Warnakulasuriya S. Causes of oral cancer–an appraisal of controversies. Br Dent J. 2009;207:471–5.CrossRefPubMed Warnakulasuriya S. Causes of oral cancer–an appraisal of controversies. Br Dent J. 2009;207:471–5.CrossRefPubMed
29.
go back to reference Palefsky J. Human papillomavirus infection in HIV-infected persons. Top HIV Med. 2007;15:130–3.PubMed Palefsky J. Human papillomavirus infection in HIV-infected persons. Top HIV Med. 2007;15:130–3.PubMed
30.
go back to reference Chaiyachati K, Cinti SK, Kauffman CA, Riddell J. HIV-infected patients with anal carcinoma who subsequently developed oral squamous cell carcinoma: report of 2 cases. Int Assoc Physicians AIDS Care (Chic). 2008;7:306–10.CrossRef Chaiyachati K, Cinti SK, Kauffman CA, Riddell J. HIV-infected patients with anal carcinoma who subsequently developed oral squamous cell carcinoma: report of 2 cases. Int Assoc Physicians AIDS Care (Chic). 2008;7:306–10.CrossRef
32.
go back to reference Chapman C, Aboulafia DM, Dezube BJ, Pantanowitz L. Human immunodeficiency virus-associated adenocarcinoma of the colon: clinicopathologic findings and outcome. Clin Colorectal Cancer. 2009;8:215–9.CrossRefPubMed Chapman C, Aboulafia DM, Dezube BJ, Pantanowitz L. Human immunodeficiency virus-associated adenocarcinoma of the colon: clinicopathologic findings and outcome. Clin Colorectal Cancer. 2009;8:215–9.CrossRefPubMed
33.
go back to reference Fattovich G, Stroffolini T, Zagni I, Donato F. Hepatocellular carcinoma in cirrhosis: incidence and risk factors. Gastroenterology. 2004;127:S35–50.CrossRefPubMed Fattovich G, Stroffolini T, Zagni I, Donato F. Hepatocellular carcinoma in cirrhosis: incidence and risk factors. Gastroenterology. 2004;127:S35–50.CrossRefPubMed
34.
go back to reference Bodaghi S, Yamanegi K, Xiao SY, Da Costa M, Palefsky JM, Zheng ZM. Colorectal papillomavirus infection in patients with colorectal cancer. Clin Cancer Res. 2005;11:2862–7.CrossRefPubMedPubMedCentral Bodaghi S, Yamanegi K, Xiao SY, Da Costa M, Palefsky JM, Zheng ZM. Colorectal papillomavirus infection in patients with colorectal cancer. Clin Cancer Res. 2005;11:2862–7.CrossRefPubMedPubMedCentral
35.
go back to reference Dalgleish AG, O’Byrne KJ. Chronic immune activation and inflammation in the pathogenesis of AIDS and cancer. Adv Cancer Res. 2002;84:231–6.CrossRefPubMed Dalgleish AG, O’Byrne KJ. Chronic immune activation and inflammation in the pathogenesis of AIDS and cancer. Adv Cancer Res. 2002;84:231–6.CrossRefPubMed
36.
go back to reference Bica I, McGovern B, Dhar R, Stone D, McGowan K, Scheib R, et al. Increasing mortality due to end-stage liver disease in patients with human immunodeficiency virus infection. Clin Infect Dis. 2001;32:492–7.CrossRefPubMed Bica I, McGovern B, Dhar R, Stone D, McGowan K, Scheib R, et al. Increasing mortality due to end-stage liver disease in patients with human immunodeficiency virus infection. Clin Infect Dis. 2001;32:492–7.CrossRefPubMed
37.
go back to reference Benhamou Y, Bochet M, Di Martino V, Charlotte F, Azria F, Coutellier A, et al. Liver fibrosis progression in human immunodeficiency virus and hepatitis C virus coinfected patients. The Multivirc Group Hepatology. 1999;30:1054–8.CrossRefPubMed Benhamou Y, Bochet M, Di Martino V, Charlotte F, Azria F, Coutellier A, et al. Liver fibrosis progression in human immunodeficiency virus and hepatitis C virus coinfected patients. The Multivirc Group Hepatology. 1999;30:1054–8.CrossRefPubMed
38.
go back to reference Bräu N, Salvatore M, Ríos-Bedoya CF, Fernández-Carbia A, Paronetto F, Rodríguez-Orengo JF, et al. Slower fibrosis progression in HIV/HCV-coinfected patients with successful HIV suppression using antiretroviral therapy. J Hepatol. 2006;44:47–55.CrossRefPubMed Bräu N, Salvatore M, Ríos-Bedoya CF, Fernández-Carbia A, Paronetto F, Rodríguez-Orengo JF, et al. Slower fibrosis progression in HIV/HCV-coinfected patients with successful HIV suppression using antiretroviral therapy. J Hepatol. 2006;44:47–55.CrossRefPubMed
39.
go back to reference Silverberg MJ, Chao C, Leyden WA, Xu L, Tang B, Horberg MA, et al. HIV infection and the risk of cancers with and without a known infectious cause. AIDS. 2009;23:2337–45.CrossRefPubMedPubMedCentral Silverberg MJ, Chao C, Leyden WA, Xu L, Tang B, Horberg MA, et al. HIV infection and the risk of cancers with and without a known infectious cause. AIDS. 2009;23:2337–45.CrossRefPubMedPubMedCentral
Metadata
Title
Risk of cancer among HIV-infected patients from a population-based nested case–control study: implications for cancer prevention
Authors
Chang-Hua Chen
Chih-Yuan Chung
Li-Hsuan Wang
Che Lin
Hsiu-Li Lin
Hsiu-Chen Lin
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2015
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-015-1099-y

Other articles of this Issue 1/2015

BMC Cancer 1/2015 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine