title: Lung cancer in the Swiss HIV Cohort Study: role of smoking, immunodeficiency and pulmonary infection.
abstract: BACKGROUND
  Immunodeficiency and AIDS-related pulmonary infections have been suggested as independent causes of lung cancer among HIV-infected persons, in addition to smoking.
  
  
  METHODS
  A total of 68 lung cancers were identified in the Swiss HIV Cohort Study (SHCS) or through linkage with Swiss Cancer Registries (1985-2010), and were individually matched to 337 controls by centre, gender, HIV-transmission category, age and calendar period. Odds ratios (ORs) were estimated by conditional logistic regression.
  
  
  RESULTS
  Overall, 96.2% of lung cancers and 72.9% of controls were ever smokers, confirming the high prevalence of smoking and its strong association with lung cancer (OR for current vs never=14.4, 95% confidence interval (95% CI): 3.36-62.1). No significant associations were observed between CD4+ cell count and lung cancer, neither when measured within 1 year (OR for <200 vs ≥500=1.21, 95% CI: 0.49-2.96) nor further back in time, before lung cancer diagnosis. Combined antiretroviral therapy was not significantly associated with lung cancer (OR for ever vs never=0.67, 95% CI: 0.29-1.52), and nor was a history of AIDS with (OR=0.49, 95% CI: 0.19-1.28) or without (OR=0.53, 95% CI: 0.24-1.18) pulmonary involvement.
  
  
  CONCLUSIONS
  Lung cancer in the SHCS does not seem to be clearly associated with immunodeficiency or AIDS-related pulmonary disease, but seems to be attributable to heavy smoking.
authors.affiliation: International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France. clifford@iarc.fr
authors.forename: G M
authors.initials: GM
authors.lastname: Clifford
authors.forename: M
authors.initials: M
authors.lastname: Lise
authors.forename: S
authors.initials: S
authors.lastname: Franceschi
authors.forename: M
authors.initials: M
authors.lastname: Egger
authors.forename: C
authors.initials: C
authors.lastname: Bouchardy
authors.forename: D
authors.initials: D
authors.lastname: Korol
authors.forename: F
authors.initials: F
authors.lastname: Levi
authors.forename: S
authors.initials: S
authors.lastname: Ess
authors.forename: G
authors.initials: G
authors.lastname: Jundt
authors.forename: G
authors.initials: G
authors.lastname: Wandeler
authors.forename: J
authors.initials: J
authors.lastname: Fehr
authors.forename: P
authors.initials: P
authors.lastname: Schmid
authors.forename: M
authors.initials: M
authors.lastname: Battegay
authors.forename: E
authors.initials: E
authors.lastname: Bernasconi
authors.forename: M
authors.initials: M
authors.lastname: Cavassini
authors.forename: A
authors.initials: A
authors.lastname: Calmy
authors.forename: O
authors.initials: O
authors.lastname: Keiser
authors.forename: F
authors.initials: F
authors.lastname: Schöni-Affolter
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications*; D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D008171:Lung Diseases / Q000150:complications; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012907:Smoking / Q000009:adverse effects*; D013557:Switzerland / Q000453:epidemiology