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Int J Cancer. 2015 Nov 15;137(10):2443-53. doi: 10.1002/ijc.29603. Epub 2015 Jun 2.

Trends in survival after cancer diagnosis among HIV-infected individuals between 1992 and 2009. Results from the FHDH-ANRS CO4 cohort.

Author information

1
INSERM, UMR_S 1136, Institut Pierre Louis D'epidémiologie Et De Santé Publique, Paris, F-75013, France.
2
Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis D'epidémiologie Et De Santé Publique, Paris, F-75013, France.
3
Hospices Civils De Lyon, Service De Biostatistique, Lyon, F-69003, France.
4
Département Des Maladies Chroniques Et Traumatismes, Institut De Veille Sanitaire, Saint-Maurice, F-94410, France.
5
CNRS UMR 5558, Laboratoire De Biométrie Et Biologie Évolutive, Equipe Biostatistique-Santé, Villeurbanne, France.
6
Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Cancer Research UK Cancer Survival Group, Faculty of Epidemiology and Population Health, London, WC1E 7HT, United Kingdom.
7
INSERM UMR 866, Registre Bourguignon Des Cancers Digestifs, FRANCIM, Centre Hospitalier Universitaire (CHU) De Dijon, Dijon, France.
8
CHU De Rennes, Hôpital Pontchaillou, Service De Maladies Infectieuses, Rennes, France.
9
Assistance Publique Hôpitaux De Paris (AP-HP), Hôpital Saint Antoine, Service De Maladies Infectieuses Et Tropicales, Paris, France.
10
Centre Hospitalier D'argenteuil, Service d'hématologie-SIDA, Argenteuil, France.
11
AP-HP, Hôpital Saint Louis, Service De Maladies Infectieuses Et Tropicales, Paris, France.
12
CHU De Reims, Service De Médecine Interne Et De Pathologie Infectieuse, Reims, France.
13
AP-HP, Hôpital Ambroise-Paré, Service De Médecine Interne, Boulogne, France.
14
AP-HP, Hôpital Tenon, Service De Pneumologie, Paris, France.
15
Département De Santé Publique, CHU De Nice, Hôpital De L'archet, Nice, France.
16
AP-HP, Groupe Hospitalier Cochin Broca Hôtel-Dieu, Service De Médecine Interne Et Centre De Référence Maladies Rares, Paris, France.
17
Sorbonne Universités, Université Paris Descartes, Paris, France.
18
AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service De Médecine Interne, Paris, France.
19
AP-HP, Hôpital Antoine Béclère, Service De Médecine Interne-Immunologie Clinique, Clamart, France.
20
AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service D'oncologie Médicale, IUC, Paris, France.
21
AP-HP, Groupe Hospitalier Cochin Broca Hôtel-Dieu, Unité De Biostatistique Et D'épidémiologie, Paris, France.

Abstract

Although the decline in cancer mortality rates with the advent of combination antiretroviral therapy (cART) in HIV-infected individuals can be mostly explained by a decrease in cancers incidence, we looked here if improved survival after cancer diagnosis could also contribute to this decline. Survival trends were analyzed for most frequent cancers in the HIV-infected population followed in the French Hospital Database on HIV: 979 and 2,760 cases of visceral and non-visceral Kaposi's sarcoma (KS), 2,339 and 461 cases of non-Hodgkin lymphoma (NHL) and Hodgkin's lymphoma (HL), 446 lung, 312 liver and 257 anal cancers. Five-year Kaplan-Meier survival rates were estimated for four periods: 1992-1996, 1997-2000, 2001-2004 and 2005-2009. Cox proportional hazard models were used to compare survival across the periods, after adjustment for confounding factors. For 2001-2004, survival was compared to the general population after standardization on age and sex. Between the pre-cART (1992-1996) and early-cART (1997-2000) periods, survival improved after KS, NHL, HL and anal cancer and remained stable after lung and liver cancers. During the cART era, 5-year survival improved after visceral and non-visceral KS, NHL, HL and liver cancer, being 83, 92, 65, 87 and 19% in 2005-2009, respectively, and remained stable after lung and anal cancers, being 16 and 65%, respectively. Compared with the general population, survival in HIV-infected individuals in 2001-2004 was poorer for hematological malignancies and similar for solid tumors. For hematological malignancies, survival continues to improve after 2004, suggesting that the gap between the HIV-infected and general populations will close in the future.

KEYWORDS:

HIV; calendar period; cancer; general population; survival

PMID:
25976897
DOI:
10.1002/ijc.29603
[Indexed for MEDLINE]
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