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1984 to 2007
Version of Record online: 29 JUL 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 23, pages 5507–5516, 1 December 2010
How to Cite
Seaberg, E. C., Wiley, D., Martínez-Maza, O., Chmiel, J. S., Kingsley, L., Tang, Y., Margolick, J. B., Jacobson, L. P. and for the Multicenter AIDS Cohort Study (MACS) (2010), Cancer incidence in the multicenter aids cohort study before and during the HAART era. Cancer, 116: 5507–5516. doi: 10.1002/cncr.25530
Data in this article were collected by the Multicenter AIDS Cohort Study (MACS) with centers at The Johns Hopkins Bloomberg School of Public Health (Joseph B. Margolick and Lisa P. Jacobson, Principal Investigators), Howard Brown Health Center, Feinberg School of Medicine, Northwestern University, and Cook County Bureau of Health Services (John P. Phair and Steven M. Wolinsky, Principal Investigators), University of California at Los Angeles (Roger Detels, Principal Investigator), and University of Pittsburgh (Charles R. Rinaldo, Principal Investigator).
See editorial on pages 5344–7, this issue.
- Issue online: 23 NOV 2010
- Version of Record online: 29 JUL 2010
- Manuscript Accepted: 16 JUN 2010
- Manuscript Revised: 3 JUN 2010
- Manuscript Received: 2 MAR 2010
- human immunodeficiency virus (HIV) infection;
- cancer incidence;
- acquired immunodeficiency syndrome (AIDS)-defining malignancy;
- highly active antiretroviral therapy (HAART)
The incidence of Kaposi sarcoma (KS) and non-Hodgkin lymphoma (NHL) among human immunodeficiency virus (HIV)-infected individuals declined after the introduction of highly active antiretroviral therapy (HAART) in the mid-1990s, but the cancer risk associated with HIV infection during the HAART era remains to be clarified.
Cancer incidence among HIV-infected and HIV-uninfected participants in the Multicenter AIDS (acquired immunodeficiency syndrome) Cohort Study (MACS) between 1984 and 2007 was compared with the expected incidence using US population-based data from the Surveillance, Epidemiology, and End Results (SEER) program. Age- and race-adjusted cancer incidence rates were also compared HIV by status and over time within the MACS. Exact statistical methods were used for all analyses.
A total of 933 incident cancers were observed during 77,320 person-years of follow-up. Compared with SEER, MACS HIV-infected men had significantly (P < .05) elevated rates of KS (standardized incidence ratio [SIR], 139.10), NHL (SIR, 36.80), Hodgkin lymphoma (HL)(SIR, 7.30), and anal cancer (SIR, 25.71). Within MACS, HIV infection was found to be independently associated with each of these cancers across the entire follow-up period, and KS (incidence rate ratio [IRR], 54.93), NHL (IRR, 11.18), and anal cancer (IRR, 18.50) were each found to be significantly elevated among HIV-infected men during the HAART era. Among these men, the incidence of KS and NHL declined (IRR, 0.13 and 0.23, respectively), the incidence of anal cancer increased (IRR, 5.84), and the incidence of HL remained statistically unchanged (IRR, 0.75) from the pre-HAART to the HAART era.
Cancer risk remains elevated among HIV-infected men who have sex with men, highlighting the continuing need for appropriate cancer screening in this population. Cancer 2010. © 2010 American Cancer Society.