Mahale P, et al. - In this study, the cancer risk was evaluated among older people living with HIV (PLWH) (age ≥50 years). Elevated cancer risk was noted among older PLWH. Despite the decrease in standardized incidence ratios (SIRs) with age, excess absolute risks (EARs) were higher for some cancers, reflecting a greater absolute excess in cancer incidence among older PLWH. In the first 5 years after HIV diagnosis, high risk for some cancers underscored the need for early HIV diagnosis and rapid treatment initiation.

Methods

• Data was gathered from the HIV/AIDS Cancer Match Study (1996-2012).
• The researchers evaluated risk of Kaposi sarcoma (KS), non-Hodgkin lymphoma (NHL), Hodgkin lymphoma, and cervical, anal, lung, liver, oral cavity/pharyngeal, breast, prostate, and colon cancers in older PLWH compared to the general population by calculating the standardized incidence ratios (SIRs) and excess absolute risks (EARs).
• Using Poisson regression, cancer risk by time since HIV diagnosis was estimated.

Results

• In this study, 10,371 cancers were identified among 183,542 older PLWH.
• Significantly increased risk was evident for KS (SIR=103.34), NHL (SIR=3.05), Hodgkin lymphoma (SIR=7.61), and cervical (SIR=2.02), anal (SIR=14.00), lung (SIR=1.71), liver (SIR=2.91), and oral cavity/pharyngeal (SIR=1.66) cancers, and reduced for breast (SIR=0.61), prostate (SIR=0.47), and colon (SIR=0.63) cancers.
• For all cancers, SIRs declined with age.
• On the other hand, EARs increased with age for anal, lung, liver, and oral cavity/pharyngeal cancers.
• Cancer risk was highest for most cancers within 5 years after HIV diagnosis.
• Since HIV diagnosis, the risk for KS, NHL, lung cancer, and Hodgkin lymphoma decreased with increasing time.