title: Risk of cancer among HIV-infected patients from a population-based nested case-control study: implications for cancer prevention.
abstract: BACKGROUND
  The burden of cancer is likely to increase among the human immunodeficiency virus (HIV)-positive population as it ages due to successful antiretroviral therapy (ART). The purpose of this study was to determine the risk of cancer in HIV-infected patients.
  
  
  METHODS
  This study was a matched nested case-control study. It was performed using the National Health Insurance Research Database of Taiwan. The control group included non-HIV-infected patients matched by sex, age, and year of enrollment. Logistic regression analyses were performed and simultaneously adjusted for potential confounders (income, urbanization, and Charslon index of comorbidity to evaluate HIV infection as an independent risk of cancer. We calculated the overall and sex-specific standardized incidence ratios (SIR) to investigate the pattern of cancer risk and overall cancer risk in the patients with HIV infection.
  
  
  RESULTS
  Of the 1,115 HIV-infected patients, 104 (9.33%) developed cancer during the 11-year follow-up period. The risk of cancer for patients with HIV infection was significant (adjusted odds ratio = 3.89, 95% confidence interval [CI] = 2.92-5.19) after adjustment for potential confounders. There was a significantly increased risk of developing non-Hodgkin lymphoma (SIR = 25.73, 95% CI = 6.83-90.85), cervical cancer (SIR = 4.01, 95% CI = 1.0-16.06), lymphoma (SIR = 20.26, 95% CI = 5.86-70.10), and respiratory and intrathoracic cancer (SIR = 20.09, 95% CI = 2.34-172.09) compared with the control group. In addition, HIV-infected patients were at significant risk for renal, oral, breast, liver, skin, and colorectal cancer.
  
  
  CONCLUSIONS
  Patients with HIV infection are at increased risk for several specific cancers. Our results support the implementation of an active and accelerated cancer screening schedule for patients with HIV infection to increase their life span.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan. changhua@cch.org.tw.|College of Medicine & Nursing, Hung Kuang University, Taichung City, Taiwan. changhua@cch.org.tw.
authors.forename: Chang-Hua
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan. 45413@cch.org.tw.
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Chung
authors.affiliation: Department of Pharmacy, Taipei Medical University Hospital, Taipei, Taiwan. shiuan@tmu.edu.tw.|School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan. shiuan@tmu.edu.tw.
authors.forename: Li-Hsuan
authors.initials: LH
authors.lastname: Wang
authors.affiliation: Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan. chelin1chelin1@yahoo.com.tw.|Department of Environmental Engineering, National Chung-Hsing University, Taichung, Taiwan. chelin1chelin1@yahoo.com.tw.
authors.forename: Che
authors.initials: C
authors.lastname: Lin
authors.affiliation: Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan. linali@ms1.hinet.net.|Department of Neurology, General Cathay Hospital, Sijhih Branch, New Taipei City, Taiwan. linali@ms1.hinet.net.
authors.forename: Hsiu-Li
authors.initials: HL
authors.lastname: Lin
authors.affiliation: Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, No. 250 Wu-Hsing Street, 11031, Taipei, Taiwan. jane2@tmu.edu.tw.|Department of Laboratory Medicine, Taipei Medical University Hospital, Taipei, Taiwan. jane2@tmu.edu.tw.
authors.forename: Hsiu-Chen
authors.initials: HC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D011159:Population Surveillance / Q000379:methods; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult