Record linkage to correct under-ascertainment of cancers in HIV cohorts: The Sinikithemba HIV clinic linkage project
Record linkage to correct under-ascertainment of cancers in HIV cohorts: The Sinikithemba HIV clinic linkage project
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DOI：
10.1002/ijc.30154
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发表时间：
2016-09-15
影响因子：
6.4
通讯作者：
Bohlius, Julia
中科院分区：
文献类型：
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作者：
Sengayi, Mazvita;Spoerri, Adrian;Bohlius, Julia
由于缺乏系统地收集艾滋病毒队列中的癌症诊断，以及癌症登记中没有艾滋病毒状况，南非对艾滋病毒相关癌症的监测受到阻碍。为了提高癌症确诊率和估计癌症发病率，我们使用概率记录链接(PRL)方法将在夸祖鲁-纳塔尔麦考德医院(KZN)Sinikihemba HIV诊所登记的成年人(年龄=16岁)的抗逆转录病毒治疗(ART)记录与KZN省公共实验室的癌症记录联系起来。我们以95%的可信区间(CI)计算了所有癌症、卡波西肉瘤(KS)、子宫颈癌、非霍奇金淋巴瘤和非艾滋病定义癌症(NADCs)在纳入连锁识别癌症前后的发病率。共有8,721份艾滋病毒阳性患者的记录与35,536份癌症记录相关联。在2004至2010年间，我们确定了448种癌症，其中82%(n=367)仅在癌症登记中登记，10%(n=43)仅在艾滋病毒队列中登记，8%(n=38)在艾滋病毒队列和癌症登记中都登记。在纳入连锁识别的癌症后，开始接受抗逆转录病毒治疗的患者的总癌症发病率从每10万人年134例(95%可信区间91-212)增加到877例(95%可信区间744-1041)。发病率最高的是KS(432，95%CI 341-555)，其次是宫颈(259，95%CI 179-390)和NADC(294，95%CI 223-395)/10万人年。HIV队列中癌症的确定是不完整的，但PRL对于癌症确定是可行的，也是必不可少的。
The surveillance of HIV-related cancers in South Africa is hampered by the lack of systematic collection of cancer diagnoses in HIV cohorts and the absence of HIV status in cancer registries. To improve cancer ascertainment and estimate cancer incidence, we linked records of adults (aged >= 16 years) on antiretroviral treatment (ART) enrolled at Sinikithemba HIV clinic, McCord Hospital in KwaZulu-Natal (KZN) with the cancer records of public laboratories in KZN province using probabilistic record linkage (PRL) methods. We calculated incidence rates for all cancers, Kaposi sarcoma (KS), cervix, non-Hodgkin's lymphoma and non-AIDS defining cancers (NADCs) before and after inclusion of linkage-identified cancers with 95% confidence intervals (CIs). A total of 8,721 records of HIV-positive patients were linked with 35,536 cancer records. Between 2004 and 2010, we identified 448 cancers, 82% (n=367) were recorded in the cancer registry only, 10% (n=43) in the HIV cohort only and 8% (n=38) both in the HIV cohort and the cancer registry. The overall cancer incidence rate in patients starting ART increased from 134 (95% CI 91-212) to 877 (95% CI 744-1,041) per 100,000 person-years after inclusion of linkage-identified cancers. Incidence rates were highest for KS (432, 95% CI 341-555), followed by cervix (259, 95% CI 179-390) and NADCs (294, 95% CI 223-395) per 100,000 person-years. Ascertainment of cancer in HIV cohorts is incomplete, PRL is both feasible and essential for cancer ascertainment.