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American Journal of Epidemiology Vol. 154, No. 6 : 544-556
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health


ORIGINAL CONTRIBUTIONS

Cancer Incidence in New York State Acquired Immunodeficiency Syndrome Patients

Brian Gallagher1, Zhengyan Wang1, Maria J. Schymura2, Amy Kahn2 and E. James Fordyce3

1 New York State Department of Health, Bureau of HIV/AIDS Epidemiology, Albany, NY.
2 New York State Department of Health, Bureau of Chronic Disease Epidemiology and Surveillance, Albany, NY.
3 New York City Department of Health, Office of AIDS Surveillance, New York, NY.

To identify cancers that occur at higher rates in acquired immunodeficiency syndrome (AIDS) patients, the cancer experience of New York State (NYS) AIDS patients aged 15–69 years who were diagnosed between 1981 and 1994 was compared with that of the NYS general population. Sex and HIV risk group-specific standardized incidence ratios (SIRs), post-AIDS relative risks, and trends of relative risks were calculated to determine cancer risk. Among non-AIDS-related cancers, elevated SIRs were found for Hodgkin's disease (male, 8.0; female, 6.4; heterosexually infected males, 31.3); cancer of the rectum, rectosigmoid, and anus (male, 3.3; female, 3.0); trachea, bronchus, and lung (male, 3.3; female, 7.5); and brain and central nervous system (male, 3.1; female, 3.4; heterosexually infected females, 23.8) cancers. Moreover, significant trends of increasing relative risks from the pre-AIDS to the post-AIDS period were found for cancers of the rectum, rectosigmoid, and anus; trachea, bronchus, and lung; skin; and connective tissues (all sites, p < 0.05) among males. For AIDS-related cancers in women, invasive cervical cancer had an overall SIR of 9.1 (95% confidence interval: 6.9, 10.8) and a post-AIDS relative risk of 6.5 (95% confidence interval: 4.1, 9.7). This population-based registry linkage analysis evaluates cancer risk in AIDS patients by sex and risk factors and adds evidence that HIV-associated immunosuppression increases the risks of specific types of cancer.

acquired immunodeficiency syndrome; HIV; lymphoma; AIDS-related; lung neoplasms; registries; risk factors

Abbreviations: AIDS, acquired immunodeficiency syndrome; CNS, central nervous system; HIV, human immunodeficiency virus; IDU, injection drug user; MSM, men who have sex with men; NHL, non-Hodgkin's lymphoma; NYS, New York State; RR, relative risk; SIR, standardized incidence ratio


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