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Cancer risk in elderly persons with HIV/AIDS
Robert J Biggar1, Katharine A Kirby, Jonnae Atkinson
1From *Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. biggarb@mail.nih.gov
Journal of Acquired Immune Deficiency Syndromes (1999)
|June 24, 2004
Summary
Cancer risks in elderly persons with AIDS (EPWAs) mirror those in younger adults, with elevated risks for Kaposi sarcoma and non-Hodgkin lymphoma. Prostate cancer risk was notably low in this population.
Area of Science:
- Gerontology
- Oncology
- Epidemiology
Background:
- Cancer incidence is elevated in individuals with Acquired Immunodeficiency Syndrome (AIDS).
- Cancer risk profiles in elderly persons with AIDS (EPWAs) have not been previously characterized.
Purpose of the Study:
- To delineate the specific cancer risk profile among elderly individuals diagnosed with AIDS.
Main Methods:
- Utilized AIDS data from 1981-1996 to identify 8828 EPWAs (aged 60+).
- Linked EPWA records with local cancer registries to identify 1142 cancer cases.
- Calculated relative risks (RR) by comparing observed cancer cases against expected numbers derived from age-, sex-, race-, and year-matched general population data.
Main Results:
- Significantly elevated RRs observed for Kaposi sarcoma (545) and non-Hodgkin lymphoma (24.6) within 2 years post-AIDS diagnosis.
- Non-AIDS-defining cancers showed a modest overall RR of 1.3 (1.2-1.4) from 60 months pre- to 27 months post-AIDS onset.
- Excess risks for Hodgkin lymphoma, anal cancer, liver cancer, multiple myeloma, leukemia, and lung cancer were noted, similar to younger AIDS patients, but not significantly elevated in the immediate 2 years post-diagnosis.
Conclusions:
- The cancer risk profile in EPWAs largely resembles that of younger individuals with AIDS.
- Relative risks for cancers in EPWAs were generally lower, attributed to higher background cancer incidence rates in the elderly.
- The low observed risk for prostate cancer may be linked to reduced cancer screening in this demographic.