Among PLWH, cancer mortality has declined significantly through the early part of this century, but deaths due to non-AIDS-defining cancers have not dropped as much as those from non-Hodgkin’s lymphoma (NHL) or Kaposi’s sarcoma (KS), researchers reported in Clinical Infectious Diseases.
The study, which examined population-based U.S. HIV and cancer registries, found that overall cancer mortality dropped by 35% when comparing the 2001-2005 time period to the 2011-2015 time period. In 2001-2005, cancer mortality among PLWH was 484/100,000 person-years; By 2011-2015, that number had dropped to 314/100,000 PY.
However, the population-attributable fraction for non-AIDS cancers is on the rise, especially among PLWH aged 60 years or older, the researchers found. Further, even among younger PLWH—i.e., those between ages 20 and 39—the cancer mortality rate was 12 times that of the general population.
During the 2011-2015 time period, the most common non-AIDS-defining cancers among PLWH were lung, liver, and anal cancer, probably because of higher smoking rates, coinfection with HCV, and greater HPV prevalence among MSM, the authors suggested.
Study authors recommended several public health interventions to further reduce cancer mortality among PLWH:
- Early ART initiation to prevent the onset of AIDS-defining cancers.
- HCV screenings.
- Smoking cessation programs.
“Although NHL and KS are among the leading causes of cancer deaths in the HIV population, the spectrum of cancer deaths is shifting toward non–AIDS-defining sites, and mortality due to non–AIDS-defining cancers will likely rise as the HIV population ages,” they concluded.