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AIDS increases stomach, esophageal cancer risks
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Patients with AIDS are more likely than the general population to develop stomach or esophageal carcinomas and non-Hodgkin’s lymphomas, according to recent results.
Researchers evaluated data on 596,955 patients with AIDS from the HIV/AIDS Cancer Match Study, which combined data from 1980 through 2007 across 16 HIV, AIDS and cancer registries.
E. Christina Persson
“People diagnosed with AIDS are living longer due to improved therapies,” E. Christina Persson, PhD, post-doctoral fellow at the division of cancer epidemiology and genetics, National Cancer Institute, told Healio.com. “However, they remain at increased risk of developing a number of different cancers. An elevated risk of esophageal and stomach cancers had been observed before. This is the biggest study to look at this in detail, with data spanning over 30 years of the AIDS epidemic.”
The risks of carcinomas in both the esophagus (SIR=1.69; 95% CI, 1.37-2.07) and stomach (SIR=1.44; 95% CI, 1.17-1.76) were significantly elevated among patients with AIDS compared with the general population, with an incidence rate of 4.95 per 100,000 person-years for esophageal and 5.00 per 100,000 person-years for stomach carcinomas. The excess absolute risk over the general population per 100,000 person-years was 2.02 and 1.53, respectively.
In the esophagus, risks for adenocarcinoma (SIR=1.91; 95% CI, 1.31-2.70) and squamous cell carcinoma (SIR=1.47; 95% CI, 1.10-1.92) were greater for patients with AIDS, with elevated risk at all anatomic sites. In the stomach, risk was higher for all types of adenocarcinomas (SIR=1.40; 95% CI, 1.12-1.72).
Risk for non-Hodgkin’s lymphoma (NHL) was significantly higher in the stomach (SIR=35.5; 95% CI, 31.9-39.5) and esophagus (SIR=261; 95% CI, 190-349), and patients with AIDS also were more likely to develop stomach mucosa-associated lymphoid tissue lymphoma (SIR=5.99; 95% CI, 3.19-10.2).
Overall carcinoma incidence rates remained stable from 1980 through 2007 (P=.30 for esophageal and P=.58 for stomach carcinoma, after adjusting for age), but investigators noted that incidence of stomach and esophageal NHL decreased significantly after 1996 (P<.0001), when highly active antiretroviral therapy was introduced.
“Overall, people with AIDS are at higher risk for stomach and esophageal cancer than the general population,” Persson said. “The explanation for this … is uncertain, but it could be due to more frequent use of tobacco and alcohol, or perhaps obesity, among people with AIDS. Clinicians need to be aware that programs encouraging tobacco cessation and alcohol moderation may help reduce the occurrence of esophageal and stomach carcinomas among these patients.”
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