title: Trends in survival after cancer diagnosis among HIV-infected individuals between 1992 and 2009. Results from the FHDH-ANRS CO4 cohort.
abstract: Although the decline in cancer mortality rates with the advent of combination antiretroviral therapy (cART) in HIV-infected individuals can be mostly explained by a decrease in cancers incidence, we looked here if improved survival after cancer diagnosis could also contribute to this decline. Survival trends were analyzed for most frequent cancers in the HIV-infected population followed in the French Hospital Database on HIV: 979 and 2,760 cases of visceral and non-visceral Kaposi's sarcoma (KS), 2,339 and 461 cases of non-Hodgkin lymphoma (NHL) and Hodgkin's lymphoma (HL), 446 lung, 312 liver and 257 anal cancers. Five-year Kaplan-Meier survival rates were estimated for four periods: 1992-1996, 1997-2000, 2001-2004 and 2005-2009. Cox proportional hazard models were used to compare survival across the periods, after adjustment for confounding factors. For 2001-2004, survival was compared to the general population after standardization on age and sex. Between the pre-cART (1992-1996) and early-cART (1997-2000) periods, survival improved after KS, NHL, HL and anal cancer and remained stable after lung and liver cancers. During the cART era, 5-year survival improved after visceral and non-visceral KS, NHL, HL and liver cancer, being 83, 92, 65, 87 and 19% in 2005-2009, respectively, and remained stable after lung and anal cancers, being 16 and 65%, respectively. Compared with the general population, survival in HIV-infected individuals in 2001-2004 was poorer for hematological malignancies and similar for solid tumors. For hematological malignancies, survival continues to improve after 2004, suggesting that the gap between the HIV-infected and general populations will close in the future.
authors.affiliation: INSERM, UMR_S 1136, Institut Pierre Louis D'epidémiologie Et De Santé Publique, Paris, F-75013, France.|Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis D'epidémiologie Et De Santé Publique, Paris, F-75013, France.
authors.forename: Mira
authors.initials: M
authors.lastname: Hleyhel
authors.affiliation: Hospices Civils De Lyon, Service De Biostatistique, Lyon, F-69003, France.|Département Des Maladies Chroniques Et Traumatismes, Institut De Veille Sanitaire, Saint-Maurice, F-94410, France.|CNRS UMR 5558, Laboratoire De Biométrie Et Biologie Évolutive, Equipe Biostatistique-Santé, Villeurbanne, France.|Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Cancer Research UK Cancer Survival Group, Faculty of Epidemiology and Population Health, London, WC1E 7HT, United Kingdom.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Belot
authors.affiliation: INSERM UMR 866, Registre Bourguignon Des Cancers Digestifs, FRANCIM, Centre Hospitalier Universitaire (CHU) De Dijon, Dijon, France.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Bouvier
authors.affiliation: CHU De Rennes, Hôpital Pontchaillou, Service De Maladies Infectieuses, Rennes, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Tattevin
authors.affiliation: Assistance Publique Hôpitaux De Paris (AP-HP), Hôpital Saint Antoine, Service De Maladies Infectieuses Et Tropicales, Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Pacanowski
authors.affiliation: Centre Hospitalier D'argenteuil, Service d'hématologie-SIDA, Argenteuil, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Genet
authors.affiliation: AP-HP, Hôpital Saint Louis, Service De Maladies Infectieuses Et Tropicales, Paris, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: De Castro
authors.affiliation: CHU De Reims, Service De Médecine Interne Et De Pathologie Infectieuse, Reims, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Berger
authors.affiliation: AP-HP, Hôpital Ambroise-Paré, Service De Médecine Interne, Boulogne, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Dupont
authors.affiliation: AP-HP, Hôpital Tenon, Service De Pneumologie, Paris, France.
authors.forename: Armelle
authors.initials: A
authors.lastname: Lavolé
authors.affiliation: Département De Santé Publique, CHU De Nice, Hôpital De L'archet, Nice, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Pradier
authors.affiliation: AP-HP, Groupe Hospitalier Cochin Broca Hôtel-Dieu, Service De Médecine Interne Et Centre De Référence Maladies Rares, Paris, France.|Sorbonne Universités, Université Paris Descartes, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Salmon
authors.affiliation: AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service De Médecine Interne, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Simon
authors.affiliation: AP-HP, Hôpital Antoine Béclère, Service De Médecine Interne-Immunologie Clinique, Clamart, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Martinez
authors.affiliation: INSERM, UMR_S 1136, Institut Pierre Louis D'epidémiologie Et De Santé Publique, Paris, F-75013, France.|Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis D'epidémiologie Et De Santé Publique, Paris, F-75013, France.|AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service D'oncologie Médicale, IUC, Paris, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Spano
authors.affiliation: INSERM, UMR_S 1136, Institut Pierre Louis D'epidémiologie Et De Santé Publique, Paris, F-75013, France.|Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis D'epidémiologie Et De Santé Publique, Paris, F-75013, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Costagliola
authors.affiliation: INSERM, UMR_S 1136, Institut Pierre Louis D'epidémiologie Et De Santé Publique, Paris, F-75013, France.|Sorbonne Universités, Université Paris Descartes, Paris, France.|AP-HP, Groupe Hospitalier Cochin Broca Hôtel-Dieu, Unité De Biostatistique Et D'épidémiologie, Paris, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Grabar
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D001005:Anus Neoplasms / Q000401:mortality; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000401:mortality; D006689:Hodgkin Disease / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality; D008175:Lung Neoplasms / Q000401:mortality; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009369:Neoplasms / Q000401:mortality*; D012514:Sarcoma, Kaposi / Q000401:mortality; D016019:Survival Analysis
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; calendar period; cancer; general population; survival