title: Trends in cancer diagnoses and survival among persons with AIDS in a high HIV prevalence urban area.
abstract: Washington, DC (DC), has among the highest AIDS prevalence and cancer incidence in the USA. This study compared cancer diagnoses and survival among AIDS cases with AIDS-defining cancers (ADCs) to those with non-AIDS-defining cancers (NADCs) in DC from 1996 to 2006. Survival by cancer type and time period was also examined for 300 individuals diagnosed with AIDS who developed cancer; 49% of AIDS cases developed an ADC. ADC cases were younger at both AIDS and cancer diagnosis and had significantly lower median CD4 counts at AIDS diagnosis than NADC cases. The most frequent cancers were non-Hodgkin lymphoma (NHL; 44% of ADC), Kaposi's sarcoma (40% of ADC), and lung cancer (20% of NADC). There was no significant difference in distribution of cancers when comparing ADCs to NADCs, or over time (1996-2001 vs. 2002-2006). Survival among NHL, oral cavity, and lung cancer cases was 0.4, 0.8, and 0.3 years, respectively; the risk of death was approximately two times higher for each of these cancers when compared to other cancers. Given the high burden of cancer and HIV in DC, early highly active antiretroviral therapy initiation, routine cancer screening, and risk reduction through behavioral modification should be emphasized to prevent cancer among HIV-infected persons.
authors.affiliation: a Department of Epidemiology and Biostatistics , The Milken Institute School of Public Health at the George Washington University , Washington , DC , USA.
authors.forename: Amanda D
authors.initials: AD
authors.lastname: Castel
authors.forename: Heather
authors.initials: H
authors.lastname: Young
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: Akiwumi
authors.forename: Alicia
authors.initials: A
authors.lastname: Vargas
authors.forename: Kathleen
authors.initials: K
authors.lastname: Rogers
authors.forename: Tiffany
authors.initials: T
authors.lastname: West
authors.forename: Paul H
authors.initials: PH
authors.lastname: Levine
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D015995:Prevalence; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000453:epidemiology; D016019:Survival Analysis; D014505:Urban Population / Q000706:statistics & numerical data*; D014861:Washington / Q000453:epidemiology
keywords: AIDS; HIV; cancer; mortality; survival