Breast and colorectal cancer screening and staging diagnosis among people with and without HIV

Background: Older people with HIV (PWH) are increasingly developing cancers commonly seen among people without HIV (PWOH). Few studies have simultaneously evaluated both cancer screening utilization and stage at diagnosis. We compared breast and colorectal cancer screening utilization and staging at diagnosis between PWH and PWOH.Methods: Using 2010-2019 SEER-Medicare linkage data, we identified adults aged ≥51 years with breast or colorectal cancer and assessed prior HIV diagnosis and cancer screening within one year before diagnosis. Cancer stage was analyzed using categorical and ordinal scales. Each PWH was propensity-matched to up to three PWOH based on sociodemographic characteristics and comorbidities.Results: After matching, PWH with breast cancer (n = 229) had similar mammography utilization (50.2% vs. 48.1%, p = 0.59) and stage at diagnosis (median 2 for both groups) compared to PWOH. Similar findings were observed for PWH with colorectal cancer (n = 355) after matching (27.0% vs. 24.3%, p = 0.30; median 2 for both groups). Cancer screening was associated with earlier-stage diagnosis regardless of HIV status.Conclusion: PWH demonstrated comparable screening utilization and stage at diagnosis to PWOH. Screening was associated with earlier-stage diagnosis regardless of HIV status. These findings highlight encouraging progress in cancer prevention among aging PWH.