Current questions in HIV-associated lung cancer.
OBJECTIVE
In this review, we explore current questions regarding risk factors contributing to frequent and early onset of lung cancer among populations with HIV infection, treatment, and outcomes of lung cancer in HIV-infected patients as well as challenges in a newly evolving era of lung cancer screening.


RESULTS
Lung cancer, seen in three-fold excess in HIV-infected populations, has become the most common non-AIDS defining malignancy in the highly active antiretroviral therapy era. HIV-associated lung cancer appears to be associated with young age at diagnosis, cigarette smoking, advanced stage at presentation, and a more aggressive clinical course. There is no unified explanation for these observations, and aside from traditional risk factors, HIV-related immunosuppression and biological differences might play a role. In addition to smoking cessation interventions, screening and early cancer detection in HIV-infected populations are of high clinical importance, although evidence supporting lung cancer screening in this particularly high-risk subset is currently lacking, as are prospective studies of lung cancer therapy.


CONCLUSIONS
There is an urgent need for prospective clinical trials in HIV-associated lung cancer to improve understanding of lung cancer pathogenesis and to optimize patient care. Several clinical trials are in progress to address questions in cancer biology, screening, and treatment for this significant cause of mortality in persons with HIV infection.
Division of Oncology, Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10467, USA.
Marina
M
Shcherba
Jonathan
J
Shuter
Missak
M
Haigentz
D017668:Age of Onset; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D008175:Lung Neoplasms / Q000175:diagnosis / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects