Increased Risk of Stomach and Esophageal Cancer in People With AIDS

A study by E. Christina Persson of the National Cancer Institute, Rockville, MD, and colleagues indicated that there is an increased risk of cancers of the stomach and esophagus in people with AIDS.

The researchers analyzed data from 596,955 people from the HIV/AIDS Cancer Match Study, which links data from 1980 to 2007 for 16 US population-based HIV and AIDS cancer registries. They compared stomach and esophageal malignancies in people with AIDS with those of the general public and evaluated the risks of different histological and anatomic subtypes of carcinomas and non-Hodgkin lymphomas of the stomach and esophagus in people with AIDS.

Results show that people with AIDS have 69 percent and 44 percent increased risks of esophageal and stomach carcinomas respectively, compared with the general population. The incidence of carcinomas remained fairly constant over time, but rates of non-Hodgkin lymphoma decreased from 1980–2007. The incidence of both esophageal and stomach carcinomas increased with age, and the risk of these cancers among people with AIDS did not decline across calendar years even with the introduction of highly active antiretroviral therapy in 1996.

Compared with non-Hispanic White subjects, Hispanic subjects had a lower risk of esophageal carcinoma, and non-Hispanic Black and Hispanic subjects had a higher risk of stomach carcinoma. No associations were observed between sex and risk of esophageal or stomach cancer. Compared with men who have sex with men, heterosexuals with HIV had a higher risk of esophageal carcinoma. Compared with the general population, the risks of carcinomas of the esophagus or stomach were not elevated in people with HIV only; compared with people with HIV only, individuals with AIDS had a higher risk of carcinomas of the esophagus and the stomach. The CD4 count at the onset of AIDS was not associated with risk of esophageal or stomach carcinoma.

The researchers provide possible explanations for these results, including an increased prevalence of H. pylori infection in people with AIDS.

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