title: Cumulative Incidence of Cancer Among Persons With HIV in North America: A Cohort Study.
abstract: BACKGROUND
  Cancer is increasingly common among persons with HIV.
  
  
  OBJECTIVE
  To examine calendar trends in cumulative cancer incidence and hazard rate by HIV status.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  North American AIDS Cohort Collaboration on Research and Design during 1996 to 2009.
  
  
  METHODS
  86 620 persons with HIV and 196 987 uninfected adults.
  
  
  METHODS
  Cancer type-specific cumulative incidence by age 75 years and calendar trends in cumulative incidence and hazard rates, each by HIV status.
  
  
  RESULTS
  Cumulative incidences of cancer by age 75 years for persons with and without HIV, respectively, were as follows: Kaposi sarcoma, 4.4% and 0.01%; non-Hodgkin lymphoma, 4.5% and 0.7%; lung cancer, 3.4% and 2.8%; anal cancer, 1.5% and 0.05%; colorectal cancer, 1.0% and 1.5%; liver cancer, 1.1% and 0.4%; Hodgkin lymphoma, 0.9% and 0.09%; melanoma, 0.5% and 0.6%; and oral cavity/pharyngeal cancer, 0.8% and 0.8%. Among persons with HIV, calendar trends in cumulative incidence and hazard rate decreased for Kaposi sarcoma and non-Hodgkin lymphoma. For anal, colorectal, and liver cancer, increasing cumulative incidence, but not hazard rate trends, were due to the decreasing mortality rate trend (-9% per year), allowing greater opportunity to be diagnosed. Despite decreasing hazard rate trends for lung cancer, Hodgkin lymphoma, and melanoma, cumulative incidence trends were not seen because of the compensating effect of the declining mortality rate.
  
  
  CONCLUSIONS
  Secular trends in screening, smoking, and viral co-infections were not evaluated.
  
  
  CONCLUSIONS
  Cumulative cancer incidence by age 75 years, approximating lifetime risk in persons with HIV, may have clinical utility in this population. The high cumulative incidences by age 75 years for Kaposi sarcoma, non-Hodgkin lymphoma, and lung cancer support early and sustained antiretroviral therapy and smoking cessation.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Silverberg
authors.forename: Bryan
authors.initials: B
authors.lastname: Lau
authors.forename: Chad J
authors.initials: CJ
authors.lastname: Achenbach
authors.forename: Yuezhou
authors.initials: Y
authors.lastname: Jing
authors.forename: Keri N
authors.initials: KN
authors.lastname: Althoff
authors.forename: Gypsyamber
authors.initials: G
authors.lastname: D'Souza
authors.forename: Eric A
authors.initials: EA
authors.lastname: Engels
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Hessol
authors.forename: John T
authors.initials: JT
authors.lastname: Brooks
authors.forename: Ann N
authors.initials: AN
authors.lastname: Burchell
authors.forename: M John
authors.initials: MJ
authors.lastname: Gill
authors.forename: James J
authors.initials: JJ
authors.lastname: Goedert
authors.forename: Robert
authors.initials: R
authors.lastname: Hogg
authors.forename: Michael A
authors.initials: MA
authors.lastname: Horberg
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Kirk
authors.forename: Mari M
authors.initials: MM
authors.lastname: Kitahata
authors.forename: Philip T
authors.initials: PT
authors.lastname: Korthuis
authors.forename: William C
authors.initials: WC
authors.lastname: Mathews
authors.forename: Angel
authors.initials: A
authors.lastname: Mayor
authors.forename: Sharada P
authors.initials: SP
authors.lastname: Modur
authors.forename: Sonia
authors.initials: S
authors.lastname: Napravnik
authors.forename: Richard M
authors.initials: RM
authors.lastname: Novak
authors.forename: Pragna
authors.initials: P
authors.lastname: Patel
authors.forename: Anita R
authors.initials: AR
authors.lastname: Rachlis
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Sterling
authors.forename: James H
authors.initials: JH
authors.lastname: Willig
authors.forename: Amy C
authors.initials: AC
authors.lastname: Justice
authors.forename: Richard D
authors.initials: RD
authors.lastname: Moore
authors.forename: Robert
authors.initials: R
authors.lastname: Dubrow
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001005:Anus Neoplasms / Q000453:epidemiology; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000453:epidemiology; D008175:Lung Neoplasms / Q000453:epidemiology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D009656:North America / Q000453:epidemiology; D016016:Proportional Hazards Models; D012514:Sarcoma, Kaposi / Q000453:epidemiology