Donna L White1,2,3,4,5, Abiodun Oluyomi4, Kathryn Royse2, Yongquan Dong2, Harrison Nguyen2, Elaine Chang2,6, Peter Richardson2, Li Jiao1,2,3,4,5, Jose M Garcia7,8, Jennifer R Kramer2,3,4, Aaron P Thrift4,9, Elizabeth Chiao2,3,4,10. 1. Section of Gastroenterology and Hepatology, Department of Medicine, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX. 2. Clinical Epidemiology and Comparative Effectiveness Program, Department of Medicine, VA Health Services Research Center of Innovations (IQuESt), Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX. 3. Texas Medical Center Digestive Diseases Center, Houston, TX. 4. Dan L. Duncan Cancer Center at Baylor College of Medicine, Houston, TX. 5. Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX. 6. Section of Hematology and Oncology, Department of Medicine, Baylor College of Medicine, Houston, TX. 7. Department of Medicine, Geriatric Research, Education and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA. 8. Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. 9. Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX. 10. Division Infectious Diseases, Department of Internal Medicine, Baylor College of Medicine, Houston, TX.
Abstract
BACKGROUND: Although declining rates of incident AIDS-related Kaposi sarcoma (KS) have been reported, KS incidence rates have noted race/ethnic, age, and geographic diversity. We performed a comprehensive assessment of recent secular trends in AIDS-related KS incidence in the United States. METHODS: We identified incident KS diagnosed in men aged 20-54 years (who comprise most AIDS-related KS in the United States) using the US Cancer Statistics registry data. Joinpoint analysis assessed for trends in age-adjusted incidence rates between 2000 and 2014 calculating average annual percentage changes (AAPCs) with 95% confidence intervals. Heat maps were generated to compare age-adjusted HIV incidence rates with KS incidence rates. RESULTS: Age-adjusted KS incidence rates nationwide decreased from 1.44/100,000 to 0.95/100,000 between 2000 and 2014. Observed rate changes varied across subgroups; eg, there were significant decreases in 30-44 years (AAPC = -5.4%), particularly in Whites and Blacks, significant increases among 20-29 years (AAPC = 2.7), primarily in Blacks, and stable rates among 45-54 years (AAPC = -0.03). In Southern United States, the incidence rates among Blacks did not significantly change. The states with highest average age-adjusted rates over the study period were Georgia (2.71/100,000), New York (2.16/100,000), California (2.02/100,000), Florida (1.90/100,000), and Texas (1.39/100,000), with significantly decreasing trends over time, except Georgia where rates increased (AAPC = 1.8). CONCLUSIONS: Although KS incidence rates have decreased nationally, age, racial, and geographic disparities persist, including increasing risk among younger Black men and particularly elevated rates in some southern states and urban areas. Further research is needed to address racial and geographic AIDS-related KS disparities.
BACKGROUND: Although declining rates of incident AIDS-related Kaposi sarcoma (KS) have been reported, KS incidence rates have noted race/ethnic, age, and geographic diversity. We performed a comprehensive assessment of recent secular trends in AIDS-related KS incidence in the United States. METHODS: We identified incident KS diagnosed in men aged 20-54 years (who comprise most AIDS-related KS in the United States) using the US Cancer Statistics registry data. Joinpoint analysis assessed for trends in age-adjusted incidence rates between 2000 and 2014 calculating average annual percentage changes (AAPCs) with 95% confidence intervals. Heat maps were generated to compare age-adjusted HIV incidence rates with KS incidence rates. RESULTS: Age-adjusted KS incidence rates nationwide decreased from 1.44/100,000 to 0.95/100,000 between 2000 and 2014. Observed rate changes varied across subgroups; eg, there were significant decreases in 30-44 years (AAPC = -5.4%), particularly in Whites and Blacks, significant increases among 20-29 years (AAPC = 2.7), primarily in Blacks, and stable rates among 45-54 years (AAPC = -0.03). In Southern United States, the incidence rates among Blacks did not significantly change. The states with highest average age-adjusted rates over the study period were Georgia (2.71/100,000), New York (2.16/100,000), California (2.02/100,000), Florida (1.90/100,000), and Texas (1.39/100,000), with significantly decreasing trends over time, except Georgia where rates increased (AAPC = 1.8). CONCLUSIONS: Although KS incidence rates have decreased nationally, age, racial, and geographic disparities persist, including increasing risk among younger Black men and particularly elevated rates in some southern states and urban areas. Further research is needed to address racial and geographic AIDS-related KS disparities.
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