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. 2011 Apr 13;305(14):1450-9.
doi: 10.1001/jama.2011.396.

Proportions of Kaposi sarcoma, selected non-Hodgkin lymphomas, and cervical cancer in the United States occurring in persons with AIDS, 1980-2007

Meredith S Shiels  1 , Ruth M Pfeiffer, H Irene Hall, Jianmin Li, James J Goedert, Lindsay M Morton, Patricia Hartge, Eric A Engels
Affiliations

Proportions of Kaposi sarcoma, selected non-Hodgkin lymphomas, and cervical cancer in the United States occurring in persons with AIDS, 1980-2007

Meredith S Shiels et al. JAMA. .

Erratum in

  • JAMA. 2011 Oct 12;306(14):1548

Abstract

Context: Given the higher risk of AIDS-defining malignancies that include Kaposi sarcoma (KS), certain non-Hodgkin lymphomas (NHLs), and cervical cancer in persons with human immunodeficiency virus (HIV) infection, the HIV epidemic has likely contributed to the overall numbers of these cancers in the United States.

Objective: To quantify the proportions of KS, AIDS-defining NHLs, and cervical cancer in the United States that occurred among persons with AIDS from 1980 to 2007.

Design, setting, and participants: The HIV/AIDS Cancer Match Study (1980-2007) linked data from 16 US HIV/AIDS and cancer registries to identify cases with and without AIDS for KS, AIDS-defining NHLs (ie, diffuse large B-cell lymphoma [DLBCL], Burkitt lymphoma [BL], and central nervous system [CNS] lymphoma), and cervical cancer. Using linked data, we derived cancer rates for persons with and without AIDS. To estimate national counts, the rates were applied to national AIDS surveillance and US Census data.

Main outcome measure: Proportion of AIDS-defining malignancies in the United States occurring in persons with AIDS.

Results: In the United States, an estimated 81.6% (95% confidence interval [CI], 81.2%-81.9%) of 83,252 KS cases, 6.0% (95% CI, 5.8%-6.1%) of 351,618 DLBCL cases, 19.9% (95% CI, 18.1%-21.7%) of 17,307 BL cases, 27.1% (95% CI, 26.1%-28.1%) of 27,265 CNS lymphoma cases, and 0.42% (95% CI, 0.37%-0.47%) of 375,452 cervical cancer cases occurred among persons with AIDS during 1980-2007. The proportion of KS and AIDS-defining NHLs in persons with AIDS peaked in the early 1990s (1990-1995: KS, 90.5% [95% CI, 90.2%-90.8%]; DLBCL, 10.2% [95% CI, 9.9%-10.5%]; BL, 27.8% [95% CI, 25.0%-30.5%]; and CNS lymphoma, 48.3% [95% CI, 46.7%-49.8%]; all P < .001 [compared with 1980-1989]) and then declined (2001-2007: KS, 70.5% [95% CI, 68.1%-73.0%]; DLBCL, 4.7% [95% CI, 4.3%-5.2%]; BL, 21.5% [95% CI, 17.7%-25.4%]; and CNS lymphoma, 12.9% [95% CI, 10.5%-15.3%]; all P < .001 [compared with 1990-1995]). The proportion of cervical cancers in persons with AIDS increased over time (1980-1989: 0.11% [95% CI, 0.09%-0.13%]; 2001-2007: 0.71% [95% CI, 0.51%-0.91%]; P < .001).

Conclusions: In the United States, the estimated proportions of AIDS-defining malignancies that occurred among persons with AIDS were substantial, particularly for KS and some NHLs. Except for cervical cancer, the proportions of AIDS-defining malignancies occurring among persons with AIDS peaked in the mid-1990s and then declined.

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Conflict of interest statement

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Figures

Figure 1
Figure 1
Number of AIDS-defining Cancer Cases in the United States in Persons With and Without AIDS by Calendar Year Estimated counts of each malignancy that occurred among persons with and without AIDS in the United States by calendar year during 1980–2007.
Figure 2
Figure 2
Proportion of US AIDS-defining Cancer Cases With AIDS by Calendar Year Estimated proportion of cases of each malignancy that occurred among persons with AIDS in the United States by calendar year during 1980–2007. Error bars indicate 95% confidence intervals.
Figure 3
Figure 3
Number of AIDS-defining Cancer Cases in the United States in Persons With and Without AIDS, by Age Group Estimated counts of each malignancy that occurred among persons with and without AIDS in the United States by age group.
Figure 4
Figure 4
Proportion of US AIDS-defining Cancer Cases With AIDS by Age Group Estimated proportion of cases of each malignancy that occurred among persons with AIDS in the United States by age group. Error bars indicate 95% confidence intervals.
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