Gita Suneja1, Meredith S Shiels2, Rory Angulo2, Glenn E Copeland2, Lou Gonsalves2, Anne M Hakenewerth2, Kathryn E Macomber2, Sharon K Melville2, Eric A Engels2. 1. Gita Suneja, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Meredith S. Shiels, Eric A. Engels, National Cancer Institute, Bethesda, MD; Rory Angulo, Lou Gonsalves, Connecticut Department of Public Health, Hartford, CT; Glenn E. Copeland, Kathryn E. Macomber, Michigan Department of Community Health, Lansing, MI; Anne M. Hakenewerth, Texas Department of State Health Services, Austin; Sharon K. Melville, Texas Department of State Health Services, Temple, TX. gita.suneja@icloud.com. 2. Gita Suneja, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Meredith S. Shiels, Eric A. Engels, National Cancer Institute, Bethesda, MD; Rory Angulo, Lou Gonsalves, Connecticut Department of Public Health, Hartford, CT; Glenn E. Copeland, Kathryn E. Macomber, Michigan Department of Community Health, Lansing, MI; Anne M. Hakenewerth, Texas Department of State Health Services, Austin; Sharon K. Melville, Texas Department of State Health Services, Temple, TX.
Abstract
PURPOSE: HIV-infected individuals with cancer have worse survival rates compared with their HIV-uninfected counterparts. One explanation may be differing cancer treatment; however, few studies have examined this. PATIENTS AND METHODS: We used HIV and cancer registry data from Connecticut, Michigan, and Texas to study adults diagnosed with non-Hodgkin's lymphoma, Hodgkin's lymphoma, or cervical, lung, anal, prostate, colorectal, or breast cancers from 1996 to 2010. We used logistic regression to examine associations between HIV status and cancer treatment, adjusted for cancer stage and demographic covariates. For a subset of local-stage cancers, we used logistic regression to assess the relationship between HIV status and standard treatment modality. We identified predictors of cancer treatment among individuals with both HIV and cancer. RESULTS: We evaluated 3,045 HIV-infected patients with cancer and 1,087,648 patients with cancer without HIV infection. A significantly higher proportion of HIV-infected individuals did not receive cancer treatment for diffuse large B-cell lymphoma (DLBCL; adjusted odds ratio [aOR], 1.67; 95% CI, 1.41 to 1.99), lung cancer (aOR, 2.18; 95% CI, 1.80 to 2.64), Hodgkin's lymphoma (aOR, 1.77; 95% CI, 1.33 to 2.37), prostate cancer (aOR, 1.79; 95% CI, 1.31 to 2.46), and colorectal cancer (aOR, 2.27; 95% CI, 1.38 to 3.72). HIV infection was associated with a lack of standard treatment modality for local-stage DLBCL (aOR, 2.02; 95% CI, 1.50 to 2.72), non-small-cell lung cancer (aOR, 2.43; 95% CI, 1.46 to 4.03), and colon cancer (aOR, 4.77; 95% CI, 1.76 to 12.96). Among HIV-infected individuals, factors independently associated with lack of cancer treatment included low CD4 count, male sex with injection drug use as mode of HIV exposure, age 45 to 64 years, black race, and distant or unknown cancer stage. CONCLUSION: HIV-infected individuals are less likely to receive treatment for some cancers than uninfected people, which may affect survival rates.
PURPOSE:HIV-infected individuals with cancer have worse survival rates compared with their HIV-uninfected counterparts. One explanation may be differing cancer treatment; however, few studies have examined this. PATIENTS AND METHODS: We used HIV and cancer registry data from Connecticut, Michigan, and Texas to study adults diagnosed with non-Hodgkin's lymphoma, Hodgkin's lymphoma, or cervical, lung, anal, prostate, colorectal, or breast cancers from 1996 to 2010. We used logistic regression to examine associations between HIV status and cancer treatment, adjusted for cancer stage and demographic covariates. For a subset of local-stage cancers, we used logistic regression to assess the relationship between HIV status and standard treatment modality. We identified predictors of cancer treatment among individuals with both HIV and cancer. RESULTS: We evaluated 3,045 HIV-infectedpatients with cancer and 1,087,648 patients with cancer without HIV infection. A significantly higher proportion of HIV-infected individuals did not receive cancer treatment for diffuse large B-cell lymphoma (DLBCL; adjusted odds ratio [aOR], 1.67; 95% CI, 1.41 to 1.99), lung cancer (aOR, 2.18; 95% CI, 1.80 to 2.64), Hodgkin's lymphoma (aOR, 1.77; 95% CI, 1.33 to 2.37), prostate cancer (aOR, 1.79; 95% CI, 1.31 to 2.46), and colorectal cancer (aOR, 2.27; 95% CI, 1.38 to 3.72). HIV infection was associated with a lack of standard treatment modality for local-stage DLBCL (aOR, 2.02; 95% CI, 1.50 to 2.72), non-small-cell lung cancer (aOR, 2.43; 95% CI, 1.46 to 4.03), and colon cancer (aOR, 4.77; 95% CI, 1.76 to 12.96). Among HIV-infected individuals, factors independently associated with lack of cancer treatment included low CD4 count, male sex with injection drug use as mode of HIV exposure, age 45 to 64 years, black race, and distant or unknown cancer stage. CONCLUSION:HIV-infected individuals are less likely to receive treatment for some cancers than uninfected people, which may affect survival rates.
Authors: Malcolm V Brock; Craig M Hooker; Eric A Engels; Richard D Moore; Maura L Gillison; Anthony J Alberg; Jeanne C Keruly; Stephen C Yang; Richard F Heitmiller; Stephen B Baylin; James G Herman; Julie R Brahmer Journal: J Acquir Immune Defic Syndr Date: 2006-09 Impact factor: 3.731
Authors: A M Levine; P Li; T Cheung; A Tulpule; J Von Roenn; B N Nathwani; L Ratner Journal: J Acquir Immune Defic Syndr Date: 2000-08-15 Impact factor: 3.731
Authors: J J Goedert; T R Coté; P Virgo; S M Scoppa; D W Kingma; M H Gail; E S Jaffe; R J Biggar Journal: Lancet Date: 1998-06-20 Impact factor: 79.321
Authors: Gita Suneja; Matthew Boyer; Baligh R Yehia; Meredith S Shiels; Eric A Engels; Justin E Bekelman; Judith A Long Journal: J Oncol Pract Date: 2015-04-14 Impact factor: 3.840
Authors: Anna E Coghill; Ruth M Pfeiffer; Meredith S Shiels; Eric A Engels Journal: Cancer Epidemiol Biomarkers Prev Date: 2017-06-15 Impact factor: 4.254
Authors: Patrick M Younan; Christopher W Peterson; Patricia Polacino; John P Kowalski; Willimark Obenza; Hannah W Miller; Brian P Milless; Phil Gafken; Stephen C DeRosa; Shiu-Lok Hu; Hans-Peter Kiem Journal: Mol Ther Date: 2015-02-04 Impact factor: 11.454
Authors: Meredith S Shiels; Jessica Y Islam; Philip S Rosenberg; H Irene Hall; Evin Jacobson; Eric A Engels Journal: Ann Intern Med Date: 2018-05-08 Impact factor: 25.391
Authors: Keith M Sigel; Kimberly Stone; Juan P Wisnivesky; Lesley S Park; Chung Yin Kong; Michael J Silverberg; Sheldon Brown; Matthew Goetz; Maria C Rodriguez-Barradas; Cynthia Gibert; Fatma Shebl; Roger Bedimo; Roxanne Wadia; Joseph King; Kristina Crothers Journal: AIDS Date: 2019-07-01 Impact factor: 4.177
Authors: Mary Jo Trepka; Rehab Auf; Kristopher P Fennie; Diana M Sheehan; Lorene M Maddox; Theophile Niyonsenga Journal: Am J Prev Med Date: 2017-07-24 Impact factor: 5.043
Authors: Anna E Coghill; Xuesong Han; Gita Suneja; Chun Chieh Lin; Ahmedin Jemal; Meredith S Shiels Journal: Cancer Date: 2019-05-03 Impact factor: 6.860