title: Cancer risk among participants in the women's interagency HIV study.
abstract: BACKGROUND
  The HIV epidemic has been associated with an increased incidence of specific cancers. However, less is known about cancers occurring in HIV-infected women than men.
  
  
  METHODS
  To determine the risk of cancer among HIV-infected and at-risk HIV-uninfected women, cancer incidence data from the Women's Interagency HIV Study (WIHS) were compared with data from the population-based United States Surveillance, Epidemiology, and End Results (SEER) registry. Age- and race-adjusted standardized incidence ratios (SIRs) were computed and exact statistical tests were used to measure significance.
  
  
  RESULTS
  Among the 1950 women participants (1554 HIV infected, 391 HIV uninfected, and 5 HIV seroconverters), 48 cancers were diagnosed during study follow-up. Among HIV-infected women, significantly (P < 0.05) increased incidence rates were observed for all cancer types (SIR = 1.9), Kaposi sarcoma (SIR = 213.5), non-Hodgkin lymphoma (NHL) (SIR = 19.0), and lung cancer (SIR = 6.3) when compared with SEER rates. Lung cancer incidence was also elevated (P = 0.07) among the HIV-uninfected women (SIR = 6.9), when compared with SEER rates, and was similar to the SIR for HIV-infected women. While the incidence rate of NHL among HIV-infected women was significantly lower during the era of highly active antiretroviral therapy (HAART) compared with the pre-HAART era (relative risk = 0.15, P = 0.005), the incidence of NHL among HIV-infected WIHS participants remained significantly higher than in the US population (SIR = 6.4, 95% CI = 1.3-15.5).
  
  
  CONCLUSIONS
  In the HAART era, the higher rates of cancer among HIV-infected women, coupled with increased life expectancy, should lead to more intensive cancer screening and prevention efforts in this population.
authors.affiliation: Department of Medicine, University of California, San Francisco, 94122, USA. nancyh@itsa.ucsf.edu
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Hessol
authors.forename: Eric C
authors.initials: EC
authors.lastname: Seaberg
authors.forename: Susan
authors.initials: S
authors.lastname: Preston-Martin
authors.forename: L Stewart
authors.initials: LS
authors.lastname: Massad
authors.forename: Henry S
authors.initials: HS
authors.lastname: Sacks
authors.forename: Sylvia
authors.initials: S
authors.lastname: Silver
authors.forename: Sandra
authors.initials: S
authors.lastname: Melnick
authors.forename: Ovadia
authors.initials: O
authors.lastname: Abulafia
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Levine
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D011159:Population Surveillance; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents