Changing temporal trends in non-AIDS cancer mortality among people diagnosed with AIDS: San Francisco,California, 1996–2013 |
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| Institution: | 1. Departments of Clinical Pharmacy and of Medicine, University of California, 3333 California Street, Suite 420, San Francisco, CA, 94143-0613, USA;2. Department of Clinical Pharmacy, University of California, 3333 California Street, San Francisco, CA, 94143-0613, USA;3. San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 500, San Francisco, CA, 94102-6012, USA;1. Department of Urology, University of Oklahoma HSC, Oklahoma City, OK, United States;2. Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States;1. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran;2. Hyrcania Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran;3. Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran;4. Deputy of Research and Technology, Golestan University of Medical Sciences, Gorgan, Iran;5. Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran;6. Department of Pathology, Sayyad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran;7. Death Registry Unit, Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran;8. Deputy of Treatment, Golestan University of Medical Sciences, Gorgan, Iran;9. Statistics and Information Technology Office, Golestan University of Medical Sciences, Gorgan, Iran;10. Shafa Radiotherapy Center, 5 Azar Hospital, Gorgan, Iran;11. Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran;12. Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France;1. Department of Haematology and Central Haematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Switzerland;2. Department for BioMedical Research, Inselspital, Bern University Hospital, University of Bern, Switzerland;3. Foundation National Institute for Cancer Epidemiology and Registration (NICER) c/o University of Zurich, Switzerland;4. Divisions of Hematology, Department of Medicine, University Hospital Basel, Switzerland;5. Haematology, University and University Hospital Zurich, Switzerland;6. Division of Haematology and Central Haematology Laboratory, Cantonal Hospital Lucerne, Switzerland;7. Department of Haemato-Oncology, Cantonal Hospital Fribourg, Switzerland;8. Division of Haematology and Transfusion Medicine, Cantonal Hospital Aarau, Switzerland;9. Clinic for Haematology and Oncology,Cantonal Hospital St. Gallen, Switzerland;10. Service and Central Laboratory of Haematology, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, Switzerland;11. Department of Oncology, Division of Hematology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Switzerland;12. Clinic of Haematology, Oncology Institute of Southern Switzerland, Switzerland;1. Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Programme, IDIBELL, Institut Català d’Oncologia, 08908, L’Hospitalet De Llobregat, Barcelona, Spain;2. CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain;3. Prevention and Implementation Group, Section of Early Detection and Prevention, International Agency for Research on Cancer, Lyon, France;4. Hematology Laboratory, Pathology Department, Hospital Universitari de Bellvitge, 08908, L’Hospitalet De Llobregat, Barcelona, Spain;5. Hematology, IDIBELL, Institut Català d’ Oncologia, 08908, L’Hospitalet De Llobregat, Barcelona, Spain;6. Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute (IdiBGi), 17007, Girona, Spain;7. University of Cantabria – IDIVAL, Santander, Spain;8. Oncology Institute (IUOPA), University of Oviedo, Asturias, Spain;9. Department of Preventive Medicine and Public Health, University of Granada, 18071, Granada, Spain;10. Instituto de Investigación Biosanitaria de Granada, Servicio Andaluz de Salud/Universidad de Granada, 18012, Granada, Spain;11. Hematopathology Unit, Pathology Department, Hospital Clínic, University of Barcelona, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), 08036, Barcelona, Spain;12. Department of Clinical Hematology, Hospital del Mar, Barcelona, 08003, Spain;13. Grup de Recerca Aplicada en Neoplasies Hematològiques-PSMAR, Barcelona, Spain;14. ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain;15. Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain;p. Universitat Pompeu Fabra (UPF), Barcelona, Spain;q. Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain;r. Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid, Spain;s. Department of Medicine, University of Barcelona, Barcelona, Spain;1. Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Radiation Epidemiology Group, Villejuif, F-94805, France;2. Gustave Roussy, Villejuif, F-94805, France;3. University of Paris-Sud, Villejuif, F-94800, France;4. Lyon University Hospital, Lyon, France;5. Thyroid Cancer Registry of Rhone-Alpes, Lyon, France;6. Thyroid Cancer Registry of Champagne-Ardennes, France;7. Cancer Registry of Isère, France;8. French National Childhood Solid Cancer Registry, CHU Nancy, France;9. Doubs Cancer Registry, CHU Besançon, France;10. Cancer Registry of Bas-Rhin, Strasbourg, France;11. Cancer Registry of Haut-Rhin, Mulhouse, France;12. Public Health Department, University Hospital Nice, France;13. US National Cancer Institute, Bethesda, USA;1. Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia;2. Centre for Population Health Research, School of Health Sciences, Sansom Institute for Health Research, University of South Australia, North Terrace, Adelaide, SA, 5000, Australia;3. Aboriginal Health Research Group, Sansom Institute for Health Research, University of South Australia, North Terrace, Adelaide, SA, 5000, Australia |
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| Abstract: | BackgroundAntiretroviral therapy (ART) has reduced AIDS-defining cancer (ADC) mortality, but its effect on non-AIDS-defining cancer (NADC) mortality is unclear. To help inform cancer prevention and screening, we evaluated trends in NADC mortality among people with AIDS (PWA) in the ART era.MethodsThis retrospective cohort study analyzed AIDS surveillance data, including causes of death from death certificates, for PWA in San Francisco who died in 1996–2013. Proportional mortality ratios (PMRs), and year, age, race, sex-adjusted standardized mortality ratios (SMRs) were calculated for 1996–1999, 2000–2005, and 2006–2013, corresponding to advances in ART.ResultsThe study included 5822 deceased PWA of whom 90% were male and 68% were aged 35–54 at time of death. Over time, the PMRs significantly decreased for ADCs (2.6%, 1.4%, 1.2%) and increased for NADCs (4.3%, 7.0%, 12.3%). For all years combined (1996–2013) and compared to the California population, significantly elevated SMRs were observed for these cancers: all NADCs combined (2.1), anal (58.4), Hodgkin lymphoma (10.5), liver (5.2), lung/larynx (3.0), rectal (5.2), and tongue (4.7). Over time, the SMRs for liver cancer (SMR 19.8, 11.2, 5.0) significantly decreased while the SMRs remained significantly elevated over population levels for anal (SMR 123, 48.2, 45.5), liver (SMR 19.8, 11.2, 5.0), and lung/larynx cancer (SMR 5.3, 4.7, 3.6).ConclusionA decline in ADC PMRs and increase in NADC PMRs represent a shift in the cancer burden, likely due to ART use. Moreover, given their elevated SMRs, anal, liver, and lung/larynx cancer remain targets for improved cancer prevention, screening, and treatment. |
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| Keywords: | AIDS Cancer Mortality Standardized mortality ratio (SMR) Trends |
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