HIV is an independent risk factor for smoking-related cancers, especially in women, an analysis from two large U.S. cohorts published in AIDS found.
Researchers used data on 6,789 men in the Multicenter AIDS Cohort Study, beginning in 1984, and on 4,423 women in the Women’s Interagency HIV Study, beginning in 1994. They analyzed data through 2018. Those study periods span the pre--, early-,and modern antiretriviral therapy eras, but there was little change in estimated rates of smoking-related cancers across these periods.
During the study period, 214 men and 192 women developed one of three cancers: lung, bronchus, or larynx. The age-adjusted incidence rates for these cancers were 348 in PLWH compared to 162 in HIV-negative participants, and 392 in women compared to 198 in men.
In PLWH, an estimated 31% of these cancers were attributable to more than five pack-years of smoking over the course of a person’s lifetime. (The study authors noted that other research has shown that heightened cancer risk persists in PLWH five years after they stop using cigarettes.)
“These data lend strong support for integrating smoking cessation interventions into ongoing HIV programs and educating PLWH, especially women, about the harm of smoking and the benefits of quitting to reduce their risk of smoking-related cancers,” study authors concluded.