Incidence of types of cancer among HIV-Infected persons compared with the general population in the United States, 1992-2003
Incidence of types of cancer among HIV-Infected persons compared with the general population in the United States, 1992-2003
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DOI：
10.7326/0003-4819-148-10-200805200-00005
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发表时间：
2008-05-20
影响因子：
39.2
通讯作者：
Brooks, John T.
中科院分区：
文献类型：
--
作者：
Patel, Pragna;Hanson, Debra L.;Brooks, John T.
背景：艾滋病毒感染者患某些类型癌症的风险可能高于一般人群。目的：比较1992 ~ 2003年艾滋病病毒感染者与普通人群的癌症发病率。设计：前瞻性观察队列研究。背景：美国。患者：54 780名艾滋病毒感染者来自成人和青少年艾滋病毒疾病谱系项目（47 832名患者）和艾滋病毒门诊研究（6948名患者），他们在1992年至2003年期间提供了157 819人年的随访，以及来自13个地理上确定的、基于人群的中央癌症登记处的监测、流行病学和最终结果项目的334 802 121份记录。测量方法：标准化比率（SRRs）用于比较艾滋病毒感染人群的癌症发病率与一般人群的标准化癌症发病率。结果：艾滋病毒感染者中下列类型的非艾滋病定义性癌症的发病率明显高于一般人群：肛门（SRR, 42.9 [95% CI， 34.1至53.3]），阴道（21.0 [CI， 11.2至35.9]），霍奇金淋巴瘤（14.7 [CI， 11.6至18.2]），肝脏（7.7 [CI， 5.7至10.1]），肺（3.3 [CI， 2.8至3.9]），黑色素瘤（2.6 [CI， 1.9至3.6]），口咽（2.6 [CI， 1.9至3.4]），白血病（2.5 [CI， 1.6至3.8]），结直肠（2.3 [CI， 1.8至2.9]）和肾脏（1.8 [CI， 1.1至2.7]）。hiv感染者的前列腺癌发病率明显低于一般人群（SRR, 0.6 [CI, 0.4 ~ 0.8]）。只有肛门癌的相对发病率随着时间的推移而增加。局限性：在HIV队列中较低的癌症确定率可能导致低估比率差异的潜在偏差。烟草使用作为一种风险因素以及癌症筛查实践变化的影响无法评估。结论：1992年至2003年，艾滋病病毒感染者中多种非艾滋病定义性癌症的发病率高于一般人群。
Background: Persons who are HIV-infected may be at higher risk for certain types of cancer than the general population.Objective: To compare cancer incidence among HIV-infected persons with incidence in the general population from 1992 to 2003.Design: Prospective observational cohort studies.Setting: United States.Patients: 54 780 HIV-infected persons in the Adult and Adolescent Spectrum of HIV Disease Project (47 832 patients) and the HIV Outpatient Study (6948 patients), who contributed 157 819 person-years of follow-up from 1992 to 2003, and 334 802 121 records from the Surveillance, Epidemiology, and End Results program of 13 geographically defined, population-based, central cancer registries.Measurements: Standardized rate ratios (SRRs) to compare cancer incidence in the HIV-infected population with standardized cancer incidence in the general population.Results: The incidence of the following types of non-AIDS-defining cancer was significantly higher in the HIV-infected population than in the general population: anal (SRR, 42.9 [95% CI, 34.1 to 53.3]), vaginal (21.0 [CI, 11.2 to 35.9]), Hodgkin lymphoma (14.7 [CI, 11.6 to 18.2]), liver (7.7 [CI, 5.7 to 10.1]), lung (3.3 [CI, 2.8 to 3.9]), melanoma (2.6 [CI, 1.9 to 3.6]), oropharyngeal (2.6 [CI, 1.9 to 3.4]), leukemia (2.5 [CI, 1.6 to 3.8]), colorectal (2.3 [CI, 1.8 to 2.9]), and renal (1.8 [CI, 1.1 to 2.7]). The incidence of prostate cancer was significantly lower among HIV-infected persons than the general population (SRR, 0.6 [CI, 0.4 to 0.8]). Only the relative incidence of anal cancer increased over time.Limitations: Lower ascertainment of cancer in the HIV cohorts may result in a potential bias to underestimate rate disparities. Tobacco use as a risk factor and the effect of changes in cancer screening practices could not be evaluated.Conclusion: The incidence of many types of non-AIDS-defining cancer was higher among HIV-infected persons than among the general population from 1992 to 2003.