While effective antiretroviral therapy, which suppresses HIV replication and improves immune function, has resulted in increased longevity for people living with HIV and reduced the risk of certain cancers, including Kaposi sarcoma and non-Hodgkin lymphoma, other cancers are expected to become more common as this patient population ages. According to a population-based study investigating the projected cancer incidence rates among adults living with HIV, by 2030, prostate and lung cancers are expected to be the most common cancers in this population. The study findings show that cancer will remain an important comorbid condition as people with HIV live longer and age, highlighting the need for expanded access to HIV therapies and cancer prevention, screening, and treatment. The study by Shiels et al is published in Annals of Internal Medicine.
The researchers used population-based data on HIV and cancer to project cancer incidence rates in the adult HIV population and the HIV Optimization and Prevention Economics (HOPE) model to forecast the number of people living with HIV through 2030, and then calculated projected cancer burden.
Cancer incidence in this population was estimated from the National Cancer Institute’s HIV/AIDS Cancer Match Study. The researchers applied those rates to projections of the number of HIV-infected people from the Centers for Disease Control and Prevention to estimate the future cancer burden.
According to the study findings, by 2030, the proportion of adult people living with HIV in the United States aged 65 years or older is projected to increase from 8.5% in 2010 to 21.4% in 2030. Age-specific rates are projected to decrease through 2030 across age groups for Kaposi sarcoma, non-Hodgkin lymphoma, cervical cancer, lung cancer, Hodgkin lymphoma, and other cancer types combined, and among those aged 65 years or older for colon cancer.
However, prostate cancer and lung cancer rates are projected to increase. The estimated total cancer burden in people living with HIV will decrease from 8,150 cases in 2010 (2,730 of AIDS-defining cancer [ADC] and 5,420 of non-AIDS-defining cancer [NADC]) to 6,690 cases in 2030 (720 of ADC and 5,980 of NADC). In 2030, prostate cancer (n = 1,590) and lung cancer (n = 1,030) are projected to be the most common cancer types.
“We have shown that the number of incident cancer diagnosis among people living with HIV will shift substantially through 2030. The incidence rates of most cancer types will likely remain stable or decrease, with the largest declines for non-Hodgkin lymphoma and Kaposi sarcoma. In 2030, prostate and lung cancer are projected to be the most common types, followed by liver and anal cancer. Although the total burden of cancer among people living with HIV is expected to decrease by 18%, cancer will remain an important comorbid condition, and tailored public health programs focused on cancer prevention, screening, and treatment in people living with HIV are needed,” concluded the study authors.
Meredith Shiels, PhD, MHS, an investigator with the National Cancer Institute, Division of Cancer Epidemiology and Genetics, Infections and Immunoepidemiology Branch, is the corresponding author of this study.
Funding for this study was provided by the National Cancer Institute and the Centers for Disease Control and Prevention.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.