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Cancer. 2018 Dec 1;124(23):4520-4528. doi: 10.1002/cncr.31702. Epub 2018 Oct 22.

Disparities in human papillomavirus-related cancer incidence and survival among human immunodeficiency virus-infected Hispanics living in the United States.

Author information

1
University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico.
2
Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico.
3
Division of Cancer Epidemiology and Genetics, National Cancer Institute‬, Rockville, Maryland.
4
The University of MD Anderson Cancer Center, Houston, Texas.
5
University of Puerto Rico/MD Anderson Cancer Center Partnership for Excellence in Cancer Research Program, San Juan, Puerto Rico.
6
District of Columbia Cancer Registry, Department of Health, Washington, District of Columbia.

Abstract

BACKGROUND:

Human papillomavirus (HPV) causes 10% of cancers among human immunodeficiency virus (HIV)-infected people in the United States. Because Hispanics are disproportionally affected by the HIV epidemic and by infection-related cancers, this study compared incidence rates for HPV-related cancers and survival between Hispanics and non-Hispanic whites (NHWs) and non-Hispanic blacks (NHBs) in the HIV-infected US population.

METHODS:

Based on data from the HIV/AIDS Cancer Match Study, standardized incidence ratios (SIRs) were used to estimate cancer risk in HIV-infected Hispanics and the general US Hispanic population. Among HIV-infected people, cancer rates were compared with incidence rate ratios (IRRs), and survival was compared with hazard ratios between Hispanics and NHWs and NHBs.

RESULTS:

Five hundred two HPV-related cancers occurred in 864,067 person-years of follow-up among HIV-infected Hispanics. Except for oropharyngeal cancer, the risk of HPV-related cancers was higher among HIV-infected Hispanics than in the general population (SIR range, 3.59 [cervical cancer] to 18.7 [anal cancer in men]). Among HIV-infected females, Hispanics had higher cervical cancer rates than NHWs (IRR, 1.70; 95% confidence interval [CI], 1.19-2.43) but lower vulvar cancer rates than NHWs (IRR, 0.40; 95% CI, 0.24-0.67) and NHBs (IRR, 0.62; 95% CI, 0.41-0.95). Among HIV-infected males, Hispanics had higher penile cancer rates than NHWs (IRR, 2.60; 95% CI, 1.36-4.96) but lower anal cancer rates than NHWs (IRR, 0.54; 95% CI, 0.46-0.63) and NHBs (IRR, 0.65; 95% CI, 0.56-0.77). Among HIV-infected Hispanics, 5-year survival was greater than 50% across HPV-related cancer types, with no major differences by racial/ethnic group.

CONCLUSIONS:

HIV-infected Hispanics have an elevated risk for HPV-related cancers. Similarly to the general population, HIV-infected Hispanics have higher rates of cervical and penile cancer than NHWs and NHBs. HPV vaccination should be promoted among HIV-infected individuals to reduce the burden of HPV-related cancers.

KEYWORDS:

Hispanics; cancer; human immunodeficiency virus (HIV); human papillomavirus (HPV); human papillomavirus-related cancers

PMID:
30345506
DOI:
10.1002/cncr.31702

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