4.7 Article

Projected Cancer Incidence Rates and Burden of Incident Cancer Cases in HIV-Infected Adults in the United States Through 2030

Journal

ANNALS OF INTERNAL MEDICINE
Volume 168, Issue 12, Pages 866-+

Publisher

AMER COLL PHYSICIANS
DOI: 10.7326/M17-2499

Keywords

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Funding

  1. Intramural Research Program of the National Cancer Institute
  2. SEER Program of the National Cancer Institute: Connecticut [HHSN261201300019I]
  3. SEER Program of the National Cancer Institute: New Jersey [HHSN261201300021I, N01-PC-2013-00021]
  4. National Program of Cancer Registries of the Center for Disease Control and Prevention: Colorado [NU58DP006347-01]
  5. National Program of Cancer Registries of the Center for Disease Control and Prevention: Georgia [5U58DP003875-01]
  6. National Program of Cancer Registries of the Center for Disease Control and Prevention: Maryland [5NU58DP003919-05-00]
  7. National Program of Cancer Registries of the Center for Disease Control and Prevention: Michigan [17NU58DP006334]
  8. National Program of Cancer Registries of the Center for Disease Control and Prevention: New Jersey [NU58/DP003931-05-00]
  9. National Program of Cancer Registries of the Center for Disease Control and Prevention: New York [U58/DP003879]
  10. National Program of Cancer Registries of the Center for Disease Control and Prevention: Texas [1NU58DP006308]
  11. state of New Jersey
  12. state of Maryland
  13. Maryland Cigarette Restitution Fund
  14. state of New York
  15. National HIV Surveillance System of the Center for Disease Control and Prevention HIV Incidence and Case Surveillance Branch: Colorado [NU62PS003960]
  16. National HIV Surveillance System of the Center for Disease Control and Prevention HIV Incidence and Case Surveillance Branch: Connecticut [5U62PS001005-05]
  17. National HIV Surveillance System of the Center for Disease Control and Prevention HIV Incidence and Case Surveillance Branch: Michigan [U62PS004011-02]
  18. National HIV Surveillance System of the Center for Disease Control and Prevention HIV Incidence and Case Surveillance Branch: New Jersey [U62PS004001-2]

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Background: Persons living with HIV (PLWH) have an elevated risk for certain types of cancer. With modern antiretroviral therapy, PLWH are aging and cancer rates are changing. Objective: To project cancer incidence rates and burden (number of new cancer diagnoses) among adult PLWH in the United States through 2030. Design: Descriptive. Setting: HIV/AIDS Cancer Match Study to project cancer rates and HIV Optimization and Prevention Economics model to project HIV prevalence. Participants: HIV-infected adults. Measurements: Projected cancer rates and burden among HIV-infected adults in the United States by age during 2006 to 2030 for AIDS-defining cancer (ADC)-that is, Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer-and certain types of non-AIDS-defining cancer (NADC). All other cancer types were combined. Results: The proportion of adult PLWH in the United States aged 65 years or older is projected to increase from 8.5% in 2010 to 21.4% in 2030. Age-specific rates are projected to decrease through 2030 across age groups for Kaposi sarcoma, non-Hodgkin lymphoma, cervical cancer, lung cancer, Hodgkin lymphoma, and other cancer types combined, and among those aged 65 years or older for colon cancer. Prostate cancer rates are projected to increase. The estimated total cancer burden in PLWH will decrease from 8150 cases in 2010 (2730 of ADC and 5420 of NADC) to 6690 cases in 2030 (720 of ADC and 5980 of NADC). In 2030, prostate cancer (n = 1590) and lung cancer (n = 1030) are projected to be the most common cancer types. Limitation: Projections assume that current trends in cancer incidence rates, HIV transmission, and survival will continue. Conclusion: The cancer burden among PLWH is projected to shift, with prostate and lung cancer expected to emerge as the most common types by 2030. Cancer will remain an important comorbid condition, and expanded access to HIV therapies and cancer prevention, screening, and treatment is needed.

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