title: Risk for cancer among people living with AIDS, 1997-2012: the São Paulo AIDS-cancer linkage study.
abstract: Previous studies have reported an increased risk for certain types of cancer in the HIV-infected population. The aim of this study was to assess the risk for cancer in people with AIDS (PWA) in comparison with the general population in São Paulo (Brazil), between 1997 and 2012. A population-based registry linkage study was carried out to assess the risk for cancer, using a standardized incidence ratio (SIR) approach. A total of 480 102 person-years, of which 337 941 (70.4%) person-years were men, were included in the analysis. Around 2074 cancer cases were diagnosed among PWA, of which 51.0% were non-AIDS-defining cancers (NADC). The risk for AIDS-defining cancers and NADC in the male population with AIDS was significantly higher than that in the general population (SIR=27.74 and 1.87, respectively), as it was in the female population with AIDS compared with the general population (SIR=8.71 and 1.44, respectively). Most virus-related NADC occurred at elevated rates among PWA: anal cancer (SIR=33.02 in men and 11.21 in women), liver (SIR=4.35 in men and 4.84 in women), vulva and vagina (SIR=6.78 in women) and Hodgkin lymphoma (SIR=5.84 in men and 2.71 in women). Lung (SIR=2.24 in men and 2.60 in women) and central nervous system (SIR=1.92 in men and 3.48 in women) cancers also occurred at increased rates. Cancer burden among PWA in São Paulo was similar to that described in high-income countries such as the USA and Italy following the introduction of the highly active antiretroviral therapy. As coinfection with oncogenic viruses disproportionally affects this population, virus-related cancers accounted for a great share of excessive cases.
authors.affiliation: Center for International Health.|Department of Epidemiology, School of Public Health.|Department of Epidemiology, Population-based Cancer Registry of São Paulo, University of São Paulo.
authors.forename: Luana F
authors.initials: LF
authors.lastname: Tanaka
authors.affiliation: Department of Epidemiology, School of Public Health.|Department of Epidemiology, Population-based Cancer Registry of São Paulo, University of São Paulo.
authors.forename: Maria R D O
authors.initials: MRDO
authors.lastname: Latorre
authors.affiliation: Programa Municipal DST-AIDS, Secretaria Municipal de Saúde.
authors.forename: Eliana B
authors.initials: EB
authors.lastname: Gutierrez
authors.affiliation: A. C. Camargo Cancer Center, São Paulo, Brazil.|International Prevention Research Institute, Lyon, France.
authors.forename: Maria P
authors.initials: MP
authors.lastname: Curado
authors.affiliation: Center for International Health.|Division of Infectious Diseases and Tropical Medicine.
authors.forename: Guenter
authors.initials: G
authors.lastname: Froeschl
authors.affiliation: Institute of Statistics, University of Munich (LMU), Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Heumann
authors.affiliation: Division of Infectious Diseases and Tropical Medicine.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Herbinger
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D013997:Time Factors