期刊
BRITISH JOURNAL OF CANCER
卷 95, 期 5, 页码 642-648出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/sj.bjc.6603282
关键词
breast cancer; endometrial cancer; ovarian cancer; human immunodeficiency virus (HIV); acquired immunodeficiency syndrome (AIDS); risk factors
类别
资金
- Intramural NIH HHS Funding Source: Medline
- NCRR NIH HHS [M01-RR-00071, M01 RR000083, M01 RR000079, M01 RR000071, M01-RR-00083, M01-RR-00079] Funding Source: Medline
- NIAID NIH HHS [U01-AI-42590, U01-AI-34993, U01 AI034993, U01 AI031834, U01 AI034994, U01 AI035004, U01-AI-31834, U01-AI-35004, U01-AI-34994, U01 AI034989, U01 AI042590, U01-AI-34989] Funding Source: Medline
- NICHD NIH HHS [U01 HD032632, U01-HD-32632] Funding Source: Medline
By linking HIV/AIDS and cancer surveillance data in 12 US regions, breast and reproductive cancer risks with AIDS were compared to those in the general population. Trends in standardized incidence ratios (SIRs) were assessed by CD4 count, AIDS-relative time, and calendar time. Standardized incidence ratios were indirectly adjusted for cancer risk factors using data from AIDS cohort participants and the general population. With AIDS, 313 women developed breast cancer (SIR 0.69, 95% confidence interval (CI) 0.62 - 0.77), 42 developed ovary cancer (SIR 1.05, 95% CI, 0.75 - 1.42), and 31 developed uterine corpus cancer (SIR 0.57, 95% CI, 0.39 - 0.81). Uterine cancer risk was reduced significantly after age 50 (SIR 0.33). Breast cancer risk was reduced significantly both before (SIR 0.71) and after (SIR 0.66) age 50, and was lower for local or regional (SIR 0.54) than distant (SIR 0.89) disease. Breast cancer risk varied little by CD4 count (P-trend = 0.47) or AIDS-relative time (P-trend = 0.14) or after adjustment for established cancer risk factors. However, it increased significantly between 1980 and 2002 (P-trend = 0.003), approaching the risk of the general population. We conclude that the cancer deficit reflected direct or indirect effects of HIV/AIDS and that anti-HIV therapy reduced these effects.
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