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Do Persons With AIDS Develop Common Types of Cancer at Younger Ages? FREE

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The summary below is from the full report titled “Age at Cancer Diagnosis Among Persons With AIDS in the United States.” It is in the 5 October 2010 issue of Annals of Internal Medicine (volume 153, pages 452-460). The authors are M.S. Shiels, R.M. Pfeiffer, and E.A. Engels.


Ann Intern Med. 2010;153(7):I-48. doi:10.7326/0003-4819-153-7-201010050-00004
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What is the problem and what is known about it so far?

The risk for many common types of cancer, such as colon, breast, or prostate, increases with age. Screening guidelines for these types therefore include recommendations on the age at which to begin screening. However, some physicians are concerned that HIV-infected persons are developing common types of cancer at younger ages than other persons. It has been suggested that HIV infection may accelerate the aging of cells and lead to an increased risk for such types of cancer at younger ages.

Why did the researchers do this particular study?

To see whether persons with AIDS actually develop cancer earlier than the general population; if so, HIV-infected persons may need to be screened at younger ages than current guidelines recommend.

Who was studied?

212 055 persons with AIDS who were followed for cancer during the highly active antiretroviral therapy era in the United States.

How was the study done?

Data from 15 U.S. population–based HIV/AIDS and cancer registries in areas with a large HIV-infected population were linked. The researchers developed models that enabled data to be corrected for the different age spread of the AIDS population and the general population.

What did the researchers find?

Overall, persons with AIDS did not develop most common types of cancer earlier than the general population; they only seemed to develop cancer earlier in previous studies because cancer tends to occur later in life and most persons with AIDS are younger than 65 years. As time progresses, the population of persons with AIDS will age and more closely match the general population in age distribution.

Although the study did not show that persons with AIDS develop most common types of cancer earlier, persons with AIDS were more likely to develop lung or anal cancer at somewhat earlier ages than the general population.

What were the limitations of the study?

Registry data did not include whether people smoked, and smoking is a known risk factor for lung cancer. It is not known whether persons with AIDS differ from the general population in how much they smoke or at what age they start smoking. The registries also did not consistently record data on Hispanic ethnicity.

What are the implications of the study?

For most types of cancer, persons who have AIDS do not differ in age at the time of cancer diagnosis from those who do not. On the basis of this study, it is not necessary to change guidelines on the age at which to start cancer screening according to whether someone has AIDS.

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