New projections show substantial increases in prostate, lung cancer rates in HIV adults

  • Ann Intern Med

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Cancer burden among adult people living with HIV (PLWH) is projected to shift substantially through 2030.
  • Overall incidence rates will remain stable with largest declines seen in Hodgkin lymphoma (HL) and Kaposi sarcoma (KS).
  • Prostate, lung cancers will emerge as most common cancer types.

Why this matters

  • Clinical interventions should focus on cancer prevention and antiretroviral treatment.
  • Early detection, treatment of certain screen-detectable cancers (breast, lung, cervical) are recommended.

Key results

  • Number of US adult PLWH is projected to increase to 1.17 million (2018) and decline to 1.09 million by 2030.
  • Proportion of PLWH >65 years will increase from 39.4% (2010) to 47.7% (2030).
  • Cancer burden composition will shift overall.
  • By 2030, prostate cancer will be the most common cancer (1590 cases; uncertainty estimate [UE]: 1240-1820), followed by lung (1030 cases, UE: 940-1090) and liver (480 cases, UE: 360-630).
  • Largest declines for non-HL (−1040 cases), KS (−880 cases); largest increases for prostate (+840 cases), lung (+200 cases), liver cancer (+120 cases).

Study design

  • Descriptive modeling study of HIV/Cancer Match study and HIV Optimization and Prevention Economics study data projecting cancer incidence rates and prevalent cases in the United States adult HIV population through 2030.
  • Funding: National Cancer Institute.

Limitations

  • Uncertain inputs (cancer burden estimates).
  • Limited power affects projected trends.

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