Trends in Kaposi's sarcoma and non-Hodgkin's lymphoma incidence in the United States from 1973 through 1998
Trends in Kaposi's sarcoma and non-Hodgkin's lymphoma incidence in the United States from 1973 through 1998
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DOI：
10.1093/jnci/94.16.1204
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发表时间：
2002-08-21
期刊：
影响因子：
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通讯作者：
Biggar, RJ
中科院分区：
文献类型：
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作者：
Eltom, MA;Jemal, A;Biggar, RJ
背景：自1981年艾滋病流行以来，卡波西肉瘤(KS)和非霍奇金淋巴瘤(NHL)在普通人群中的发病率明显上升。然而，在1990年代，艾滋病流行的动态发生了变化，人类免疫缺陷病毒(艾滋病毒)感染率放缓，推出了有效的抗逆转录病毒疗法。我们研究了这些变化对KS和NHL总体人群发病率的影响。方法：1973年至1998年KS和NHL的年龄标准化发病率来自参与监测、流行病学和最终结果(SEER)计划的9个基于人群的癌症登记机构。结果：在20世纪90年代中期，KS在所有9个登记处的发病率都急剧下降。KS发病率的下降在旧金山最为明显，那里的白人男性KS发病率从1973年的每10万人中有0.5人上升到1987年至1991年的31.1至33.3之间，然后在1998年下降到2.8。背景非霍奇金淋巴瘤在一般人群中的发病率远高于KS，与艾滋病流行相关的发病率变化在艾滋病高危人群中最为明显。在旧金山，白人男性的非霍奇金淋巴瘤发病率从1973年的10.7上升到1995年的峰值31.4，然后在1998年下降到21.6。与艾滋病相关性最高的非霍奇金淋巴瘤类型下降最快，而与艾滋病无关的非霍奇金淋巴瘤类型的发病率稳定或上升。结论：1990年代中期以来KS和NHL发病率的变化可能反映了1990年代引入有效的抗逆转录病毒治疗后艾滋病患者数量的下降和这些患者免疫功能的改善。值得注意的是，与艾滋病无关的非霍奇金淋巴瘤发病率在1998年期间继续稳步上升。
Background: The incidence of Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL) in the general population has markedly increased since the onset of the AIDS epidemic in 1981. However, during the 1990s, the dynamics of the AIDS epidemic changed, as human immunodeficiency virus (HIV) infection rates slowed and effective antiretroviral therapies were introduced. We examined the impact of these changes on the general population incidence of KS and NHL. Methods: Age-standardized incidences for KS and NHL from 1973 through 1998 were obtained from nine population-based cancer registries that participate in the Surveillance, Epidemiology and End Results (SEER) program. Results: During the mid-1990s, KS incidence declined sharply in all nine registries. Decreases in KS incidence were most evident in San Francisco, where KS rates among white men had risen from 0.5 per 100 000 people per year in 1973 to between 31.1 and 33.3 from 1987 through 1991 and then declined to 2.8 in 1998. With background NHL incidence in the general population being much higher than that for KS, changes in incidence related to the AIDS epidemic were most evident in subgroups at high risk of AIDS. In San Francisco, NHL rates among white men rose from 10.7 in 1973 to a peak of 31.4 in 1995 and then declined to 21.6 in 1998. NHL types that were most highly AIDS-associated declined most steeply, whereas the incidence of NHL types not associated with AIDS was either stable or increasing. Conclusion: Changes in KS and NHL incidence since the mid 1990s may reflect declines in the number of individuals with AIDS and improved immune function in such individuals following the introduction of effective antiretroviral therapies in the 1990s. Notably, non-AIDS-associated NHL incidence has continued to increase steadily through 1998.