title: Lung cancer in HIV patients and their parents: a Danish cohort study.
abstract: BACKGROUND
  HIV patients are known to be at increased risk of lung cancer but the risk factors behind this are unclear.
  
  
  METHODS
  We estimated the cumulative incidence and relative risk of lung cancer in 1) a population of all Danish HIV patients identified from the Danish HIV Cohort Study (n = 5,053) and a cohort of population controls matched on age and gender (n = 50,530) (study period; 1995 - 2009) and 2) their parents (study period; 1969 - 2009). Mortality and relative risk of death after a diagnosis of lung cancer was estimated in both populations.
  
  
  RESULTS
  29 (0.6%) HIV patients vs. 183 (0.4%) population controls were diagnosed with lung cancer in the observation period. HIV patients had an increased risk of lung cancer (adjusted incidence rate ratio (IRR); 2.38 (95% CI; 1.61 - 3.53)). The IRR was considerably increased in HIV patients who were smokers or former smokers (adjusted IRR; 4.06 (95% CI; 2.66 - 6.21)), male HIV patients with heterosexual route of infection (adjusted IRR; 4.19 (2.20 - 7.96)) and HIV patients with immunosuppression (adjusted IRR; 3.25 (2.01 - 5.24)). Both fathers and mothers of HIV patients had an increased risk of lung cancer (adjusted IRR for fathers; 1.31 (95% CI: 1.09 - 1.58), adjusted IRR for mothers 1.35 (95% CI: 1.07 - 1.70)). Mortality after lung cancer diagnose was increased in HIV patients (adjusted mortality rate ratio 2.33 (95%CI; 1.51 - 3.61), but not in the parents. All HIV patients diagnosed with lung cancer were smokers or former smokers.
  
  
  CONCLUSIONS
  The risk was especially increased in HIV patients who were smokers or former smokers, heterosexually infected men or immunosuppressed. HIV appears to be a marker of behavioural or family related risk factors that affect the incidence of lung cancer in HIV patients.
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Kbh Ø, Denmark. fren74@gmail.com
authors.forename: Frederik N
authors.initials: FN
authors.lastname: Engsig
authors.forename: Gitte
authors.initials: G
authors.lastname: Kronborg
authors.forename: Carsten S
authors.initials: CS
authors.lastname: Larsen
authors.forename: Gitte
authors.initials: G
authors.lastname: Pedersen
authors.forename: Court
authors.initials: C
authors.lastname: Pedersen
authors.forename: Jan
authors.initials: J
authors.lastname: Gerstoft
authors.forename: Niels
authors.initials: N
authors.lastname: Obel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000235:genetics; D018288:Carcinoma, Small Cell / Q000453:epidemiology / Q000235:genetics; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D020022:Genetic Predisposition to Disease; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007121:Immunocompetence; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D010290:Parents; D016016:Proportional Hazards Models; D012042:Registries; D012107:Research Design; D012307:Risk Factors; D012725:Sexual Behavior; D012907:Smoking / Q000453:epidemiology