Study finds increased risk of some cancers among HIV-positive people in U.S.

May 22 2008

HIV-positive people in the U.S., many of whom are living longer because of antiretroviral drugs, are at an increased risk for certain types of cancers, according to a study published Tuesday in the Annals of Internal Medicine, Reuters reports.

The study was conducted among 54,780 HIV-positive people and was based on cancer trends from 1992 to 2003. It found that as of 2003, anal cancer was 59 times more common among HIV-positive people than among the general population. In addition, Hodgkin's disease was 18 times more common among people living with HIV, followed by liver cancer at seven times more common, lung cancer at 3.6 times more common, skin cancer melanoma and throat cancer both at three times more common, and colorectal cancer at 2.4 times more common. Rates of Kaposi's sarcoma and non-Hodgkin lymphoma, which have typically been associated with HIV/AIDS, became relatively less common among people living with the disease, according to the study.

CDC's Pragna Patel, who led the study, said the most significant finding is the higher risk for anal cancer even in the "era" of highly active antiretroviral therapy. She added that multiple factors could explain the increased risk but that the risk might be linked to the spread of human papillomavirus, which is known to cause anal cancer, among men who have sex with men.

The study also found that prostate cancer was less common among HIV-positive people compared with the general population. Researchers explained that HIV-positive people possibly have a smaller risk for prostate cancer because men with HIV are more likely to have low testosterone levels, which could provide some protection against the cancer.

"The study was done because we all know that now people with HIV are living longer, and HIV is looking more like a chronic disease," Patel said, adding, "So we wanted to look at one of the other very large chronic killers in America -- cancer." Patel called the study the largest analysis of cancer trends ever done among HIV-positive people in the U.S., adding that doctors who provide care for HIV-positive people should be aware of the increased risk for certain cancers among their patients and consider screening for the conditions (Dunham, Reuters, 5/20).

The study is available online.