title: Survival among HIV-infected and HIV-uninfected individuals with common non-AIDS-defining cancers.
abstract: BACKGROUND
  Non-AIDS-defining cancers increasingly contribute to mortality among human immunodeficiency virus (HIV)-infected individuals. However, few studies have compared cancer prognosis by HIV status with adjustment for risk factors.
  
  
  METHODS
  We conducted a cohort study of HIV-infected and HIV-uninfected adults in Kaiser Permanente California during 1996 to 2011, following subjects diagnosed with Hodgkin lymphoma or anal, prostate, colorectal, or lung cancers. We used Kaplan-Meier curves and Cox regression to assess cancer-related mortality within 5 years, comparing HIV-infected with HIV-uninfected subjects. Adjusted models included age, race/ethnicity, sex, cancer stage, cancer treatment, and smoking.
  
  
  RESULTS
  Among HIV-infected and HIV-uninfected subjects, there were 68 and 51 cases of Hodgkin lymphoma, 120 and 28 of anal cancer, 150 and 2,050 of prostate cancer, 53 and 646 of colorectal cancer, and 80 and 507 of lung cancer, respectively. Five-year cancer-related survival was reduced for HIV-infected compared with HIV-uninfected subjects, reaching statistical significance for lung cancer (10% vs. 19%, P = 0.002) but not Hodgkin lymphoma (83% vs. 89%, P = 0.40) or anal (64% vs. 74%, P = 0.38), prostate (86% vs. 92%, P = 0.074), or colorectal cancers (49% vs. 58%, P = 0.55). Adjusted results were similar, with lung cancer [HR, 1.3; 95% confidence interval (CI), 1.0-1.7] and prostate cancer (HR, 2.1; 95% CI, 1.1-4.1) reaching significance.
  
  
  CONCLUSIONS
  Cancer-related mortality was higher among HIV-infected compared with HIV-uninfected individuals for prostate and lung cancers, but not Hodgkin lymphoma, anal cancer, or colorectal cancer.
  
  
  CONCLUSIONS
  Our findings emphasize the need for a focus on prevention, early detection, and adequate treatment of cancer among HIV-infected individuals.
authors.affiliation: Kaiser Permanente Northern California, Oakland, California.
authors.forename: Julia L
authors.initials: JL
authors.lastname: Marcus
authors.affiliation: Kaiser Permanente Southern California, Pasadena, California.
authors.forename: Chun
authors.initials: C
authors.lastname: Chao
authors.affiliation: Kaiser Permanente Northern California, Oakland, California.
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Leyden
authors.affiliation: Kaiser Permanente Southern California, Pasadena, California.
authors.forename: Lanfang
authors.initials: L
authors.lastname: Xu
authors.affiliation: Kaiser Permanente Northern California, Oakland, California.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Yu
authors.affiliation: Mid-Atlantic Permanente Research Institute, Rockville, Maryland.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Horberg
authors.affiliation: Kaiser Permanente Northern California, San Leandro, California.
authors.forename: Daniel
authors.initials: D
authors.lastname: Klein
authors.affiliation: Kaiser Permanente Southern California, Los Angeles, California.
authors.forename: William J
authors.initials: WJ
authors.lastname: Towner
authors.affiliation: Kaiser Permanente Northern California, Oakland, California.
authors.forename: Charles P
authors.initials: CP
authors.lastname: Quesenberry
authors.affiliation: San Francisco General Hospital, San Francisco, California. University of California San Francisco, San Francisco, California.
authors.forename: Donald I
authors.initials: DI
authors.lastname: Abrams
authors.affiliation: Kaiser Permanente Northern California, Oakland, California. michael.j.silverberg@kp.org.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Silverberg
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D012307:Risk Factors; D016019:Survival Analysis