The changing pattern of ano-rectal cancer, squamous cell carcinoma of the eye, and Hodgkin's lymphoma as non-AIDS-defining cancers, by HIV status, in Tanzania over 11 years (2002-2012): a retrospective case-report study.
BACKGROUND
In Tanzania, 5.1% of adults aged 15-49 are infected with HIV. While rates of HIV-related malignancies have declined globally with antiretroviral therapy (ART), including Tanzania, rates of non-AIDS-defining cancers (NADCs) are believed to have increased. Therefore, we determined trends of three NADCs in Tanzania: ano-rectal cancer, squamous cell carcinoma of the eye, and Hodgkin's lymphoma.


METHODS
This study was conducted at the Ocean Road Cancer Institute (ORCI) in Dar es Salaam. All medical records of patients diagnosed with ano-rectal cancer, squamous cell carcinoma of the eye, and Hodgkin's lymphoma between 2002 and 2012 were reviewed regarding HIV status, cancer clinical characteristics and management. Analysis was conducted to determine trends and proportions in these three NADCs and patient characteristics.


RESULTS
We identified 980 NADCs. The relative proportion of these three NADCs at ORCI out of all cancers treated increased from 2.37% in 2002 to a peak of 4.34% in 2009. The prevalence of HIV in patients diagnosed with these NADCs also increased-from 6.67% in 2002 to 20.87% in 2010-and 85% of squamous cell carcinoma of the eye cancer patients with a reported HIV status were HIV-positive.


CONCLUSIONS
The frequency and proportions of these three NADCs in Tanzania have increased over the past 11 years, as has the prevalence of HIV positivity amongst these NADC patients. The current and possibly increasing burden of NADCs in Tanzania and other low- and middle-income countries with high HIV rates should be a focus for future cancer prevention and control and HIV therapy programs.
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI USA.
Clare
C
Meernik
Department of Epidemiology, University of Nebraska Medical Center College of Public Health, Omaha, NE USA.
Amr S
AS
Soliman
Ocean Road Cancer Institute, Dar es Salaam, Tanzania.
Twalib
T
Ngoma
Ocean Road Cancer Institute, Dar es Salaam, Tanzania.
Crispin
C
Kahesa
Ocean Road Cancer Institute, Dar es Salaam, Tanzania.
Julius
J
Mwaiselage
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI USA.
Sofia D
SD
Merajver
HIV; Non-AIDS-defining cancer; Ocean Road Cancer Institute; Squamous cell carcinoma of the eye; Tanzania