title: Risk of Cancer among Commercially Insured HIV-Infected Adults on Antiretroviral Therapy.
abstract: The objective of this study was to explore the cancer incidence rates among HIV-infected persons with commercial insurance who were on antiretroviral therapy and compare them with those rates in the general population. Paid health insurance claims for 63,221 individuals 18 years or older, with at least one claim with a diagnostic code for HIV and at least one filled prescription for an antiretroviral medication between January 1, 2006, and September 30, 2012, were obtained from the LifeLink® Health Plan Claims Database. The expected number of cancer cases in the general population for each gender-age group (<30, 30-39, 40-49, 50-59, and >60 years) was estimated using incidence rates from the Surveillance Epidemiology and End Results (SEER) program. Standardized incidence ratios (SIRs) were estimated using their 95% confidence intervals (CIs). Compared to the general population, incidence rates for HIV-infected adults were elevated (SIR, 95% CI) for Kaposi sarcoma (46.08; 38.74-48.94), non-Hodgkin lymphoma (4.22; 3.63-4.45), Hodgkin lymphoma (9.83; 7.45-10.84), and anal cancer (30.54; 25.62-32.46) and lower for colorectal cancer (0.69; 0.52-0.76), lung cancer (0.70; 0.54, 0.77), and prostate cancer (0.54; 0.45-0.58). Commercially insured, treated HIV-infected adults had elevated rates for infection-related cancers, but not for common non-AIDS defining cancers.
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Jeannette Y
authors.identifier: 0000-0003-3536-2442
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Duke University, Durham, NC, USA.
authors.forename: Ishwori
authors.initials: I
authors.lastname: Dhakal
authors.affiliation: University of Washington, Seattle, WA, USA.
authors.forename: Corey
authors.initials: C
authors.lastname: Casper
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: Ariela
authors.initials: A
authors.lastname: Noy
authors.affiliation: University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Palefsky
authors.affiliation: Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Missak
authors.initials: M
authors.lastname: Haigentz
authors.affiliation: AIDS Malignancy Consortium, New York, NY, USA.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Krown
authors.affiliation: Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Ambinder
authors.affiliation: University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Ronald T
authors.initials: RT
authors.lastname: Mitsuyasu