Cancer burden attributable to cigarette smoking among HIV-infected people in North America.
Cancer burden attributable to cigarette smoking among HIV-infected people in North America.
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DOI：
10.1097/qad.0000000000001721
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发表时间：
2018-02-20
期刊：
影响因子：
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通讯作者：
Engels EA
中科院分区：
文献类型：
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作者：
Altekruse SF;Shiels MS;Modur SP;Land SR;Crothers KA;Kitahata MM;Thorne JE;Mathews WC;Fernández-Santos DM;Mayor AM;Gill JM;Horberg MA;Brooks JT;Moore RD;Silverberg MJ;Althoff KN;Engels EA
通过联合抗逆转录病毒疗法，艾滋病毒感染者的寿命更长，癌症负担增加。鉴于艾滋病毒感染人群中吸烟的高流行率，我们研究了吸烟导致的癌症发病风险。在北美艾滋病队列研究与设计合作联盟中，对HIV感染者进行了270，136人-年随访的观察性队列。在52，441名参与者中，2306人在2000-2015年期间被诊断患有癌症。所有癌症合并、吸烟相关癌症和非吸烟所致癌症的估计风险比（HR）和人群归因分数（PAF）。癌症患者吸烟的频率（79%）高于非癌症患者（73%）。调整人口统计学和临床因素后，吸烟与总体癌症风险增加有关（HR=1.33 [95%置信区间：1.18-1.49]）;吸烟相关癌症（HR=2.31 [1.80-2.98]），肺癌（HR=17.80 [5.60-56.63]）;但非吸烟相关性癌症（HR=1.12 [0.98-1.28]）。与吸烟相关的校正PAF如下：所有癌症合并，PAF=19% [95%置信区间：13%-25%];吸烟相关癌症，PAF=50% [39%-59%];肺癌，PAF=94% [82%-98%];非吸烟相关癌症，PAF=9% [1%-16%]。在艾滋病毒感染者中，大约五分之一的癌症，包括一半与吸烟有关的癌症，以及94%的肺癌诊断可以通过消除吸烟来预防。吸烟可能导致一些癌症，这些癌症在本报告中被归类为非吸烟相关癌症。需要加强针对艾滋病毒感染者的戒烟努力。
With combination-antiretroviral therapy, HIV-infected individuals live longer with an elevated burden of cancer. Given the high prevalence of smoking among HIV-infected populations, we examined the risk of incident cancers attributable to ever smoking cigarettes. Observational cohort of HIV-infected participants with 270,136 person-years of follow-up in the North American AIDS Cohort Collaboration on Research and Design consortium. Among 52,441 participants; 2306 were diagnosed with cancer during 2000–2015. Estimated hazard ratios (HR) and population-attributable fractions (PAF) associated with ever cigarette smoking for all cancers combined, smoking-related cancers, and cancers that were not attributed to smoking. People with cancer were more frequently ever smokers (79%) compared to people without cancer (73%). Adjusting for demographic and clinical factors, cigarette smoking was associated with increased risk of cancer overall (HR=1.33 [95% confidence interval: 1.18–1.49]); smoking-related cancers (HR=2.31 [1.80–2.98]), lung cancer (HR=17.80 [5.60–56.63]); but not non-smoking-related cancers (HR=1.12 [0.98–1.28]). Adjusted PAFs associated with ever cigarette smoking were as follows: all cancers combined, PAF=19% [95% confidence interval: 13%–25%]; smoking-related cancers, PAF=50% [39%–59%]; lung cancer, PAF=94% [82%–98%]; and non-smoking-related cancers, PAF=9% [1%–16%]. Among HIV-infected persons, approximately one fifth of all incident cancer, including half of smoking-related cancer, and 94% of lung cancer diagnoses could potentially be prevented by eliminating cigarette smoking. Cigarette smoking could contribute to some cancers that were classified as non-smoking-related cancers in this report. Enhanced smoking cessation efforts targeted to HIV-infected individuals are needed.