title: Association Between Educational Level and Risk of Cancer in HIV-infected Individuals and the Background Population: Population-based Cohort Study 1995-2011.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV)-infected individuals have increased risk of cancer. To our knowledge, no previous study has examined the impact of socioeconomic position on risk and prognosis of cancer in HIV infection.
  
  
  METHODS
  Population-based cohort-study, including HIV-infected individuals diagnosed (without intravenous drug abuse or hepatitis C infection) (n = 3205), and a background population cohort matched by age, gender, and country of birth (n = 22 435) were analyzed. Educational level (low or high) and cancer events were identified in Danish national registers. Cumulative incidences, incidence rate ratios (IRRs), and survival using Kaplan-Meier methods were estimated.
  
  
  RESULTS
  Low educational level was associated with increased risk of cancer among HIV-infected individuals compared to population controls: all (adjusted-IRRs: 1.4 [95% confidence interval {CI}, 1.1-1.7] vs 1.1 [95% CI, .9-1.2]), tobacco- and alcohol-related (2.1 [95% CI, 1.3-3.4] vs 1.3 [95% CI, 1.1-1.6]), and other (1.7 [95% CI, 1.1-2.8] vs 0.9 [95% CI, .7-1.0]). Educational level was not associated with infection-related or ill-defined cancers. One-year-survival was not associated with educational level, but HIV-infected individuals with low educational level had lower 5-year-survival following infection-related and ill-defined cancers.
  
  
  CONCLUSIONS
  Education is associated with risk and prognosis of some cancers in HIV infection, and diverges from what is observed in the background population.
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Legarth
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet.
authors.forename: Lars H
authors.initials: LH
authors.lastname: Omland
authors.affiliation: Institute of Cancer Epidemiology, Danish Cancer Society.
authors.forename: Susanne O
authors.initials: SO
authors.lastname: Dalton
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre Hospital.
authors.forename: Gitte
authors.initials: G
authors.lastname: Kronborg
authors.affiliation: Department of Infectious Diseases, Aarhus University Hospital.
authors.forename: Carsten S
authors.initials: CS
authors.lastname: Larsen
authors.affiliation: Department of Infectious Diseases, Odense University Hospital.
authors.forename: Court
authors.initials: C
authors.lastname: Pedersen
authors.affiliation: Department of Infectious Diseases, Aalborg University Hospital, Denmark.
authors.forename: Gitte
authors.initials: G
authors.lastname: Pedersen
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet.
authors.forename: Jan
authors.initials: J
authors.lastname: Gerstoft
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet.
authors.forename: Niels
authors.initials: N
authors.lastname: Obel
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality; D018570:Risk Assessment; D016019:Survival Analysis
keywords: HIV infection; cancer; educational level; mortality