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. 2022 Feb;23(2):134-145.
doi: 10.1111/hiv.13179. Epub 2021 Sep 28.

Time trends in cancer incidence in Australian people living with HIV between 1982 and 2012

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Time trends in cancer incidence in Australian people living with HIV between 1982 and 2012

Ian K J Wong et al. HIV Med. 2022 Feb.

Abstract

Objectives: The aim of the study was to describe time trends in cancer incidence in people living with HIV (PLHIV) in Australia between 1982 and 2012.

Methods: A population-based prospective study was conducted using data linkage between the national HIV and cancer registries. Invasive cancers identified in PLHIV were grouped into AIDS-defining cancers (ADCs), infection-related non-ADCs (NADCs), and non-infection-related NADCs. Crude and age-standardized incidence rates of cancers were calculated and compared over five time periods: 1982-1995, 1996-1999, 2000-2004, 2005-2008 and 2009-2012, roughly reflecting advances in HIV antiretroviral therapy. Standardized incidence ratios (SIRs) compared with the Australian general population were calculated for each time period. Generalized linear models were developed to assess time trends in crude and age-standardized incidences.

Results: For ADCs, the crude and age-standardized incidences of Kaposi sarcoma and non-Hodgkin lymphoma substantially declined over time (P-trend < 0.001 for all) but SIRs remained significantly elevated. For infection-related NADCs, there were significant increases in the crude incidences of anal, liver and head and neck cancers. Age-standardized incidences increased for anal cancer (P-trend = 0.002) and liver cancer (P-trend < 0.001). SIRs were significantly elevated for anal cancer, liver cancer and Hodgkin lymphoma. For non-infection-related NADCs, the crude incidence of colorectal, lung and prostate cancers increased over time, but age-standardized incidences remained stable.

Conclusions: Continuous improvements and high coverage of antiretroviral therapy have reduced the incidence of ADCs in PLHIV in Australia. Clinical monitoring of anal and liver cancers in people living with HIV should be performed, given the increasing incidence of these cancers.

Keywords: Australia; HIV; cancer; data linkage; incidence.

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Conflict of interest statement

IMP has received travel funding from Seqiris Australia in 2018. MTVL is a Postdoctoral fellow of the National Health and Medical Research Council (1012141). ML has received research grants from Gilead Sciences, Janssen-Cilag and ViiV Healthcare.

Figures

Figure 1:
Figure 1:
Age-standardised incidence per 100,000 of cancer in the Australian HIV population between 1982-2012 stratified by age group a) AIDS defining cancers b) infection related non-AIDS defining cancers
Figure 1:
Figure 1:
Age-standardised incidence per 100,000 of cancer in the Australian HIV population between 1982-2012 stratified by age group a) AIDS defining cancers b) infection related non-AIDS defining cancers

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