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Smoking cessation reduces risk of cancers in people with HIV; lung cancer most stubborn
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SEATTLE — Just 1 year after quitting smoking, people with HIV face roughly the same risk of acquiring most cancers as those with the virus who had never smoked, according to a study.
Data from the assessment of participants in the D:A:D study were presented at the Conference on Retroviruses and Opportunistic Infections (COI).
Smoking is especially prevalent among people with HIV, said study researcher Leah Shepherd of University College London, and data on the potential benefits of quitting is needed.
“The risk of non–AIDS–related cancers, including lung (cancer), are accounting for more disease and death in HIV–positive people as they continue to live longer,” Shepherd said.
“In addition, the proportion of HIV–positive people who smoke is high, further increasing cancer risk.”
The study included 39,701 patients. At baseline, 41% were smokers, 17% were former smokers and 27% had never smoked.
In all, 2,230 patients developed cancer of some kind, at an incidence rate of 7.1 per 1,000 person years of follow-up (PYFU). Of those patients, 251 developed lung cancer at an incidence rate of 0.8 per 1,000 PYFU.
Other smoking-related cancers, excluding lung cancer, struck 516 patients at an incidence rate of 1.6 per 1,000 PYFU.
Diagnoses of all cancers combined were most common less than 1 year after quitting, as compared with patients who had never smoked, at an adjusted rate ratio (aRR) of 1.62. But after 1 year, the incidence was similar to that of those who had never smoked.
Lung cancer developed at a rate of more than 11 times greater than that of those who had never smoked less than 1 year after quitting (aRR: 11.72). It was more than eight times as likely after 5 years of being smoke free (aRR: 8.26).
Smoking-related cancers excluding lung cancer were nearly three times as likely to occur less than a year after quitting as in those who had not been smokers, but the incidence was similar to that in nonsmokers after a year.
Shepherd said there are signs that lung cancer incidence can decrease beyond the 5-year mark after quitting, although they were not statistically significant in the study.
“There was a hint of a lower risk in those who quit more than 5 years ago,” she said. “Therefore, we suggest that studies that follow people living with HIV for extended timeframes are needed to assess when the benefits of smoking cessation become apparent for HIV–positive people.” – by Joe Green
Reference:
Shepherd L, et al. Abstract 131. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 13-16, 2017; Seattle.
Disclosure: The authors reported no relevant financial disclosures.