Journal article
Cancer stage at diagnosis in patients infected with the human immunodeficiency virus and transplant recipients
Cancer, Vol.121(12), pp.2063-2071
06/15/2015
DOI: 10.1002/cncr.29324
PMCID: PMC4470321
PMID: 25739496
Abstract
It is unknown whether immunosuppression results in more aggressive, advanced stage cancers. Because cancer stage is influenced both by tumor biology and medical surveillance, the authors assessed cancer stage in individuals infected with the human immunodeficiency virus (HIV) and solid organ transplant recipients, 2 immunosuppressed groups with differences in their health care use.
The authors used data on all cases of 15 cancer types diagnosed during 1996 through 2010 in 2 studies that linked US cancer registries with HIV and transplant registries. Odds ratios (ORs) for advanced (vs local) disease were estimated comparing HIV and transplant populations with immunocompetent individuals in polytomous logistic regression models adjusted for age, sex, race, registry, and year.
A total of 8411 of 4.5 million cancer cases occurred in HIV-infected individuals and 7322 of 6.4 million cancer cases occurred in transplant recipients. Compared with immunocompetent patients with cancer, those infected with HIV were more likely to be diagnosed with distant stage lung (OR, 1.13), female breast (OR, 1.99), and prostate (OR, 1.57) cancers, whereas transplant recipients had fewer distant stage lung (OR, 0.54), female breast (OR, 0.75), and prostate (OR, 0.72) cancers. Both immunosuppressed populations had a shift toward advanced stage melanoma (ORs of 1.97 for HIV-infected individuals and 1.82 for transplant recipients) and bladder cancer (ORs of 1.42 for HIV-infected individuals and 1.54 for transplant recipients).
Bladder cancer and melanoma were more likely to be diagnosed at a nonlocal stage in both HIV-infected individuals and transplant recipients, suggesting a role for immunosuppression in their progression. In addition, we observed a shift for some common cancers toward later stages in HIV-infected individuals and toward earlier stages in transplant recipients, which is consistent with differential access to medical care or surveillance.
Details
- Title: Subtitle
- Cancer stage at diagnosis in patients infected with the human immunodeficiency virus and transplant recipients
- Creators
- Meredith S Shiels - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MarylandGlenn Copeland - Michigan Cancer Surveillance Program, Michigan Department of Community Health, Lansing, MichiganMarc T Goodman - Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CaliforniaJanna Harrell - Utah Cancer Registry, Salt Lake City, UtahCharles F Lynch - Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IowaKaren Pawlish - New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, New JerseyRuth M Pfeiffer - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MarylandEric A Engels - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
- Resource Type
- Journal article
- Publication Details
- Cancer, Vol.121(12), pp.2063-2071
- DOI
- 10.1002/cncr.29324
- PMID
- 25739496
- PMCID
- PMC4470321
- NLM abbreviation
- Cancer
- ISSN
- 0008-543X
- eISSN
- 1097-0142
- Publisher
- United States
- Grant note
- 5U58DP000824-04 / NCCDPHP CDC HHS U58 DP000807 / NCCDPHP CDC HHS U58 DP000824 / NCCDPHP CDC HHS HHSN261201000036C / NCI NIH HHS HHSH234200537009C / PHS HHS U58 DP003875 / NCCDPHP CDC HHS 5U58DP003921-03 / NCCDPHP CDC HHS U58DP12-1205 3919-03 / NCCDPHP CDC HHS 5U58DP003883-03 / NCCDPHP CDC HHS 01000024C / PHS HHS 5U62PS004015 / NCHHSTP CDC HHS HHSN261201000035C / NCI NIH HHS HSN261201000032C / PHS HHS HHSH250201000018C / PHS HHS U62 PS004015 / NCHHSTP CDC HHS N01-PC-35143 / NCI NIH HHS 5U58DP003875-01 / NCCDPHP CDC HHS U58 DP003920 / NCCDPHP CDC HHS U58 DP000848 / NCCDPHP CDC HHS N01-PC-35142 / NCI NIH HHS HHSN261201300021C / NCI NIH HHS N01-PC-35139 / NCI NIH HHS U62 PS004001 / NCHHSTP CDC HHS U58 DP003883 / NCCDPHP CDC HHS U58 DP000848-04 / NCCDPHP CDC HHS HHSN261201000035I / NCI NIH HHS U58DP000832 / NCCDPHP CDC HHS N01PC35142 / NCI NIH HHS HHSN261201000024C / NCI NIH HHS U58DP003879 / NCCDPHP CDC HHS U62 PS001005 / NCHHSTP CDC HHS 5458DP003920 / NCCDPHP CDC HHS N01-PC-2013-00021 / NCI NIH HHS HHSN2612010000 / PHS HHS U58 DP003931 / NCCDPHP CDC HHS N01PC35137 / NCI NIH HHS U58 DP003921 / NCCDPHP CDC HHS U62PS004001-2 / NCHHSTP CDC HHS U58 DP000832 / NCCDPHP CDC HHS U58 DP003879 / NCCDPHP CDC HHS 5U62PS004011-02 / NCHHSTP CDC HHS HHSN2612 / PHS HHS 1U58 DP000807-01 / NCCDPHP CDC HHS HHSN261201300021I / PHS HHS N01-PC-35137 / NCI NIH HHS HHSN261201000034C / NCI NIH HHS N01PC35139 / NCI NIH HHS P30 CA086862 / NCI NIH HHS HHSN261201000037C / NCI NIH HHS 5U58/DP003931-02 / NCCDPHP CDC HHS 5U62PS001005-0 / NCHHSTP CDC HHS N01PC35143 / NCI NIH HHS Z99 CA999999 / Intramural NIH HHS U62 PS004011 / NCHHSTP CDC HHS HHSN261201000026C / NCI NIH HHS
- Language
- English
- Date published
- 06/15/2015
- Academic Unit
- Epidemiology
- Record Identifier
- 9983996081002771
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