Cancer risk in elderly persons with HIV/AIDS.
BACKGROUND
Cancer risks in persons with AIDS are increased, but risks in elderly persons with AIDS (EPWAs) have not been previously described.


OBJECTIVE
To determine the profile of cancer risks in EPWAs.
Using AIDS data from 1981-1996, 8828 EPWAs were identified (60+ years old) and their records were linked to data in local cancer registries, finding 1142 cases. Expected case numbers were derived from the cancer incidence in the population matched for age, sex, race, calendar year, and registry.


RESULTS
Compared with the general population, the relative risk (RR) for Kaposi sarcoma was 545 (95% CI, 406-717) in the 2 years after AIDS onset. For non-Hodgkin lymphoma, the RR was 24.6 (7.5-80.3). No cervical cancers were reported in this interval. From 60 months before to 27 months after AIDS onset, the RR of non-AIDS-defining cancers (n = 548) was 1.3 (1.2-1.4). The cancer types occurring at significant excess during this period were similar to those in younger adults with AIDS: Hodgkin lymphoma (RR: 13.1), anal cancer (8.2), liver cancer (3.9), multiple myeloma (2.7), leukemia (2.4), and lung cancer (1.9). However, none was significantly elevated in the 2 years after the AIDS onset. Prostate cancer risk was low overall (RR: 0.8; 0.6-0.9).


CONCLUSIONS
The profile of cancer risks in EPWAs generally resembled that in younger adults with AIDS, although RRs were lower because of higher background incidence rates. We speculate that prostate cancer risk was low because of reduced screening for this cancer in EPWAs.
Biggar
Robert J
RJ
From *Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. biggarb@mail.nih.gov
Kirby
Katharine A
KA
Atkinson
Jonnae
J
McNeel
Timothy S
TS
Engels
Eric
E
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000453:epidemiology; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology*; D012042:Registries; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000150:complications / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000453:epidemiology