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. 2011:3:217-27.
doi: 10.2147/CLEP.S19875. Epub 2011 Jul 21.

Head and neck cancer in HIV patients and their parents: a Danish cohort study

Frederik N Engsig  1 , Jan Gerstoft, Gitte Kronborg, Carsten S Larsen, Gitte Pedersen, Court Pedersen, Niels Obel
Affiliations

Head and neck cancer in HIV patients and their parents: a Danish cohort study

Frederik N Engsig et al. Clin Epidemiol. 2011.

Abstract

Background: The mechanism for the increased risk of head and neck cancer (HNC) observed in HIV patients is controversial. We hypothesized that family-related risk factors increase the risk of HNC why we estimated the risk of this type of cancer in both HIV patients and their parents.

Methods: We estimated the cumulative incidence and incidence rate ratios (IRRs) of HNC in 1) a population of all Danish HIV patients identified from the Danish HIV Cohort Study (n = 5053) and a cohort of population controls matched on age and gender (n = 50,530) (study period; 1995-2009) and 2) the parents of HIV patients and population controls (study period 1978-2009). To assess the possible impact of human papilloma virus (HPV)-associated cancers, the sites of squamous cell HNCs were categorized as HPV related, potentially HPV related, and potentially HPV unrelated.

Results: Seventeen (0.3%) HIV patients vs 80 (0.2%) population controls were diagnosed with HNC cancer in the observation period. HIV patients had an increased risk of HNC (IRR 3.05 [95% CI 1.81-5.15]). The IRR was considerably increased in HIV patients older than 50 years (adjusted IRR; 4.58 [95% CI 2.24-9.35]), diagnosed after 1995 (adjusted IRR 6.31 [95% CI 2.82-14.08]), previous or current smoker (adjusted IRR 4.51 [95% CI 2.47-8.23]), with baseline CD4 count 350 cells/μL (adjusted IRR; 3.89 [95% CI 1.95-7.78]), and men heterosexually infected with HIV (adjusted IRR 5.54 [95% CI 1.96-15.66]). Fifteen (83%) of the HIV patients diagnosed with HNC were current or former smokers. The IRR of squamous cell HNC in HIV patients was high at HPV-relate sites, potentially HPV-related sites, and potentially HPV-unrelated sites. Both fathers and mothers of HIV patients had an increased risk of HNC (adjusted IRR for fathers 1.78 [95% CI 1.28-2.48], adjusted IRR for mothers 2.07 [95% CI 1.05-4.09]).

Conclusion: HIV appears to be a marker of behavioral or family-related risk factors that affect the incidence of HNC in HIV patients.

Keywords: HIV; head and neck cancer incidence; matched cohort; parents; population controls.

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Figures

Figure 1
Figure 1
Summary of the study design.
Figure 2
Figure 2
Cumulative incidence function for head and neck cancer among HIV patients and population controls. Abbreviation: CI, confidence interval.
Figure 3
Figure 3
Cumulative incidence function for head and neck cancer among parents of HIV patients and parents of population controls. Abbreviation: CI, confidence interval.
See this image and copyright information in PMC

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