Risk of breast, ovary, and uterine corpus cancers among 85 268 women with AIDS

• Published in: British journal of cancer Vol. 95; no. 5; pp. 642 - 648
• Main Authors: GOEDERT, J. J, SCHAIRER, C, MCNEEL, T. S, HESSOL, N. A, RABKIN, C. S, ENGELS, E. A
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 04.09.2006
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome - complications; Age; Age Factors; AIDS; Biological and medical sciences; Breast cancer; Breast Neoplasms - epidemiology; Cancer research; Continental Population Groups; Epidemiology; Female; Gynecology. Andrology. Obstetrics; HIV; Human immunodeficiency virus; Humans; Immune system; Incidence; Mammary gland diseases; Medical research; Medical sciences; Menopause; Middle Aged; Ovarian Neoplasms - epidemiology; Ovaries; Poisson Distribution; Registration; Registries; Risk; Risk factors; Surveillance; Tumors; United States - epidemiology; Uterine Neoplasms - epidemiology; Womens health; United States; North America; America; United States > US; Endometrium cancer; Ovary cancer; Epidemiology; Cancerology; endometrial cancer ovarian cancer human immunodeficiency virus (HIV); acquired immunodeficiency syndrome (AIDS); Uterine diseases; Adult; Female; Public health; Human; Immunopathology; Corpus uteri cancer; risk factors; Retroviridae; AIDS; Breast cancer; Malignant tumor; Immune deficiency; Lentivirus; Female genital diseases; Infection; Virus; Mammary gland diseases; Ovarian diseases; Viral disease; Risk factor; Human immunodeficiency virus
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6603282

By linking HIV/AIDS and cancer surveillance data in 12 US regions, breast and reproductive cancer risks with AIDS were compared to those in the general population. Trends in standardized incidence ratios (SIRs) were assessed by CD4 count, AIDS-relative time, and calendar time. Standardized incidence ratios were indirectly adjusted for cancer risk factors using data from AIDS cohort participants and the general population. With AIDS, 313 women developed breast cancer (SIR 0.69, 95% confidence interval (CI) 0.62-0.77), 42 developed ovary cancer (SIR 1.05, 95% CI, 0.75-1.42), and 31 developed uterine corpus cancer (SIR 0.57, 95% CI, 0.39-0.81). Uterine cancer risk was reduced significantly after age 50 (SIR 0.33). Breast cancer risk was reduced significantly both before (SIR 0.71) and after (SIR 0.66) age 50, and was lower for local or regional (SIR 0.54) than distant (SIR 0.89) disease. Breast cancer risk varied little by CD4 count (Ptrend=0.47) or AIDS-relative time (Ptrend=0.14) or after adjustment for established cancer risk factors. However, it increased significantly between 1980 and 2002 (Ptrend=0.003), approaching the risk of the general population. We conclude that the cancer deficit reflected direct or indirect effects of HIV/AIDS and that anti-HIV therapy reduced these effects.