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Cancer Incidence Among Adults With HIV in a Population-Based Cohort in Koreaopen access

Authors
Park, BoyoungAhn, Kyoung HwanChoi, YunsuKim, Jung HoSeong, HyeKim, Youn JeongChoi, Jun YoungSong, Joon YoungLee, EunjungJun, Yoon HeeYoon, Young KyungChoi, Won SukLee, MyungsunSeong, JaehyunKim, Shin-Woo
Issue Date
2-8월-2022
Publisher
AMER MEDICAL ASSOC
Citation
JAMA NETWORK OPEN, v.5, no.8, pp.E2224897
Indexed
SCIE
SCOPUS
Journal Title
JAMA NETWORK OPEN
Volume
5
Number
8
Start Page
E2224897
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/143802
DOI
10.1001/jamanetworkopen.2022.24897
ISSN
2574-3805
Abstract
IMPORTANCE In combination with a decreased risk of AIDS-defining cancers and improved survival of people infected with HIV, the burden of non-AIDS-defining cancer has increased markedly. Although a substantial number of studies have measured the cancer risk among people with HIV in developed countries, little research has been conducted on the risk of cancer in HIV-infected people in Asia. OBJECTIVE To examine the cancer incidence and the estimated risk of cancer among people in Korea infected with HIV compared with the general population. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study evaluated patients without cancer newly diagnosed with HIV from January 1, 2006, to December 31, 2018, using a nationwide population-based claims database embedded in the National Health Insurance Service database. Data were analyzed between December 6, 2021, and February 28, 2022. EXPOSURES Infection with HIV. MAIN OUTCOMES AND MEASURES Cancer incidence and standardized incidence rate (SIR) through indirect standardization. RESULTS A total of 11552 individuals without cancer (10 444 male [90.4%]; mean [SD] age, 39.9 [11.2] years) diagnosed with HIV were identified. The SIR for all cancers was 1.68 (95% CI, 130-1.87) in men and 1.26 (95% CI, 0.89-1.64) in women. In men, the highest SIRs were for Kaposi sarcoma (SIR, 349.10; 95% CI, 196.10-502.20) and anal cancer (SIR, 104.20: 95% CI, 55.56-149.90). The incidence of non-Hodgkin lymphoma (SIR, 15.62; 95% CI, 11.85-19.39). Hodgkin lymphoma (SIR, 16.67; 95% Cl. 4.32-29.02), and oropharyngeal cancer (SIR, 2.97; 95% CI, 1.36-4.58) in men infected with HIV was higher than in the general population. In women infected with HIV, an increased incidence of cervical cancer (SIR, 4.98; 95% CI.1.29-8.66) and non-Hodgkin lymphoma (SIR, 11.78; 95% CI, 2.35-21.21) compared with the general population was observed. The SIR of thyroid cancer in patients with HIV was lower than in the general population in both men (SIR, 0.63; 95% CI, 0.27-0.99) and women (SIR. 0.48; 95% CI, 0.06-0.90). CONCLUSIONS AND RELEVANCE In this cohort study, cancer risks, especially AIDS-defining cancer and virus-related cancer, were elevated in people with HIV. Efforts for cancer prevention, screening, and better accessibility to medical care in HIV-infected people are warranted.
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