Differences in Trends in Cancer Incidence Rates Among People With HIV During 2001-2019 by Race and Ethnicity and by Risk Group in the United States.

in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America by Qianlai Luo, Marie-Josèphe Horner, Cameron B Haas, Jennifer K McGee-Avila, Ruth M Pfeiffer, Eric A Engels, Karen Pawlish, Analise Monterosso, David J Riedel, Xiao-Cheng Wu, Lou Gonsalves, Suzanne Speers, Colby Cohen, Meredith S Shiels

TLDR

  • The study examined cancer trends among people with HIV across different racial/ethnic and transmission risk groups, finding significant differences in rates and trends.
  • The results highlight the need for targeted interventions and surveillance to address differential cancer risk among diverse populations.
  • Future research should examine the underlying causes of the disparities to develop effective strategies for reducing cancer risk.

Abstract

It is unclear whether cancer risk among people with human immunodeficiency virus (HIV, PWH) has declined equally across all racial/ethnic and transmission risk groups. We used data on PWH aged ≥20 years from the HIV/AIDS Cancer Match Study during 2001-2019. We used Poisson regression to assess time trends in incidence rates for each cancer site by racial/ethnicity and risk groups, adjusting for age, registry, and sex. We also estimated adjusted rate ratios across racial and ethnic and risk groups in 2001-2004 and 2015-2019. Trends in age-standardized rates differed across racial/ethnic groups and across risk groups for some cancers. For example, liver cancer rates declined 23% per 5-year period among White PWH, 11% among Black PWH, and 18% among Hispanic PWH. Anal cancer rates declined among men who have sex with men, were stable among people who inject drugs, and increased among other risk groups. Between 2001-2004 and 2015-2019, the relative difference in cancer incidence rates by race/ethnicity increased for Hodgkin lymphoma (HL) and liver cancer but decreased for non-Hodgkin lymphoma (NHL); by risk group, relative differences increased for NHL and liver cancer and decreased for HL and lung and anal cancers. Among PWH in the United States during 2001-2019, HL, lung, liver, and cervical cancer rate trends were different across racial/ethnic groups. HL, lung, anal, and liver cancer rate trends were different across risk groups. Future work should examine underlying causes of the differences in trends.

Overview

  • The study aimed to investigate cancer risk among people with human immunodeficiency virus (HIV) across different racial/ethnic and transmission risk groups.
  • The researchers used data from the HIV/AIDS Cancer Match Study between 2001-2019 to assess time trends in incidence rates for each cancer site by racial/ethnic group and risk group, adjusting for age, registry, and sex.
  • The primary objective of the study was to examine whether cancer risk has declined equally across all racial/ethnic and transmission risk groups among people with HIV.

Comparative Analysis & Findings

  • The study found that trends in age-standardized rates of liver cancer, anal cancer, and Hodgkin lymphoma differed across racial/ethnic groups, with decline rates varying between 11-23% per 5-year period.
  • The relative difference in cancer incidence rates by race/ethnicity increased for Hodgkin lymphoma and liver cancer, but decreased for non-Hodgkin lymphoma between 2001-2004 and 2015-2019.
  • The study also found that the rate trends for HL, lung, anal, and liver cancer differed across risk groups, with decline rates varying by group.

Implications and Future Directions

  • The study's findings suggest that future work should examine the underlying causes of the differences in trends across racial/ethnic and transmission risk groups.
  • The results have implications for public health policy and clinical practice, highlighting the need for targeted interventions and surveillance to address the differential cancer risk among diverse populations.
  • Further research is needed to identify the underlying causes of the disparities and to determine effective strategies for reducing cancer risk among people with HIV across different racial/ethnic and transmission risk groups.
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