Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Aug 22;12(8):e0182750.
doi: 10.1371/journal.pone.0182750. eCollection 2017.

Disparities in Kaposi sarcoma incidence and survival in the United States: 2000-2013

Kathryn E Royse  1 , Firas El Chaer  2   3 , E Susan Amirian  4   5 , Christine Hartman  1 , Susan E Krown  6 , Thomas S Uldrick  7 , Jeannette Y Lee  8 , Zachary Shepard  9 , Elizabeth Y Chiao  1   2
Affiliations

Disparities in Kaposi sarcoma incidence and survival in the United States: 2000-2013

Kathryn E Royse et al. PLoS One. .

Abstract

Objective: Geographic and racial disparities may contribute to variation in the incidence and outcomes of HIV-associated cancers in the United States.

Method: Using the Surveillance, Epidemiology, and End Results (SEER) database, we analyzed Kaposi sarcoma (KS) incidence and survival by race and geographic region during the combined antiretroviral therapy era. Reported cases of KS in men from 2000 to 2013 were obtained from 17 SEER cancer registries. Overall and age-standardized KS incidence rates were calculated and stratified by race and geographic region. We evaluated incidence trends using joinpoint analyses and calculated adjusted hazard ratios (aHR) for overall and KS-specific mortality using multivariable Cox proportional hazards models.

Results: Of 4,455 KS cases identified in men younger than 55 years (median age 40 years), the annual percent change (APC) for KS incidence significantly decreased for white men between 2001 and 2013 (APC -4.52, p = 0.02). The APC for AA men demonstrated a non-significant decrease from 2000-2013 (APC -1.84, p = 0.09). Among AA men in the South, however, APC has significantly increased between 2000 and 2013 (+3.0, p = 0.03). In addition, compared with white men diagnosed with KS during the same time period, AA men were also more likely to die from all causes and KS cancer-specific causes (aHR 1.52, 95% CI 1.34-1.72, aHR 1.49, 95% CI 1.30-1.72 respectively).

Conclusion: Although overall KS incidence has decreased in the U.S., geographic and racial disparities in KS incidence and survival exist.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. KS incidence in the U.S., 2000–2013, N = 4,455.
Fig 2
Fig 2. KS incidence in the U.S. by geographic region, 2000–2013.
Fig 3
Fig 3. KS incidence in the U.S. by race, 2000–2013.
Fig 4
Fig 4. KS incidence in the U.S. by race and geographic, 2000–2013.
Fig 5
Fig 5. KS survival in the U.S. by Race, 2000–2013, N = 3,793.
Fig 6
Fig 6. KS survival in the U.S. by Race and Geographic Region, 2000–2013, N = 3,793.
See this image and copyright information in PMC

References

    1. Antman K, Chang Y. Kaposi's sarcoma. N Engl J Med. 2000;342(14):1027–38. doi: 10.1056/NEJM200004063421407 - DOI - PubMed
    1. Hiatt KM, Nelson AM, Lichy JH, Fanburg-Smith JC. Classic Kaposi Sarcoma in the United States over the last two decades: a clinicopathologic and molecular study of 438 non-HIV-related Kaposi Sarcoma patients with comparison to HIV-related Kaposi Sarcoma. Modern pathology: an official journal of the United States and Canadian Academy of Pathology, Inc. 2008;21(5):572–82. - PubMed
    1. Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, Xiao W, Kim E, et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2011;29(32):4294–301. - PMC - PubMed
    1. Grulich AE, van Leeuwen MT, Falster MO, Vajdic CM. Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis. Lancet (London, England). 2007;370(9581):59–67. - PubMed
    1. Armstrong AW, Lam KH, Chase EP. Epidemiology of classic and AIDS-related Kaposi's sarcoma in the USA: incidence, survival, and geographical distribution from 1975 to 2005. Epidemiol Infect. 2013;141(1):200–6. doi: 10.1017/S0950268812000325 - DOI - PMC - PubMed