title: Spectrum of AIDS-associated malignant disorders.
abstract: BACKGROUND
  To clarify which types of cancer result from AIDS, we compared the cancer experiences of people with AIDS with those of the general population by matching population-based cancer and AIDS registries in the USA and Puerto Rico.
  
  
  METHODS
  We used a probabilistic matching algorithm to compare names, birth dates, and, where available, social-security numbers of 98,336 people with AIDS and 1,125,098 people with cancer aged less than 70 years. We defined AIDS-related cancers as those with both significantly raised incidence post-AIDS and increasing prevalence from 5 years pre-AIDS to 2 years post-AIDS.
  
  
  RESULTS
  Among people with AIDS, we found 7028 cases of Kaposi's sarcoma (KS), 1793 of non-Hodgkin lymphoma (NHL), and 712 other cases of histologically defined cancer. Incidence rates among people with AIDS were increased 310-fold for KS, 113-fold for NHL, and 1.9-fold (95% CI 1.5-2.3) for other cancers. Of 38 malignant disorders other than KS and NHL, only angiosarcoma (36.7-fold), Hodgkin's disease (7.6-fold), multiple myeloma (4.5-fold), brain cancer (3.5-fold), and seminoma (2.9-fold) were raised and increasing significantly (p<0.02) from the pre-AIDS to the post-AIDS period.
  
  
  CONCLUSIONS
  Interpretation is complicated by screening and shared risk factors, such as sexual behaviour and cigarette smoking. However, our data indicate that AIDS leads to a significantly increased risk of Hodgkin's disease, multiple myeloma, brain cancer, and seminoma. Immunological failure to control herpes or other viral infections may contribute to these malignant diseases.
authors.affiliation: Viral Epidemiology Branch, National Cancer Institute, Rockville, MD, USA. jg8s@nih.gov
authors.forename: J J
authors.initials: JJ
authors.lastname: Goedert
authors.forename: T R
authors.initials: TR
authors.lastname: Coté
authors.forename: P
authors.initials: P
authors.lastname: Virgo
authors.forename: S M
authors.initials: SM
authors.lastname: Scoppa
authors.forename: D W
authors.initials: DW
authors.lastname: Kingma
authors.forename: M H
authors.initials: MH
authors.lastname: Gail
authors.forename: E S
authors.initials: ES
authors.lastname: Jaffe
authors.forename: R J
authors.initials: RJ
authors.lastname: Biggar
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000465:Algorithms; D005260:Female; D006801:Humans; D015994:Incidence; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000821:virology; D011159:Population Surveillance; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology; D012042:Registries; D012306:Risk; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000453:epidemiology* / Q000821:virology; D014481:United States / Q000453:epidemiology