Spectrum and incidence trends of AIDS and non-AIDS defining cancers between 2010-2015 in the French Dat'AIDS cohort
Menée en France à partir de données 2010-2015 portant sur 44 642 personnes infectées par le VIH, cette étude de cohorte analyse l'évolution de l'incidence des cancers classant SIDA et non classant SIDA par localisation
Background: Cancer risk is higher in people living with HIV (PLWH) compared with the general population and cancers related to age are expected being most prevalent. Methods: We determined the spectrum and incidence rates of AIDS-defining cancers (ADCs), non-AIDS-defining cancers (NADCs) and of lung, Hodgkin lymphoma (HL), head and neck (HNC), colon-rectum, anal, liver, breast, prostate and urinary bladder cancers between 01/2010 and 12/2015 in the French Dat'AIDS cohort. Incidence rates were calculated by year and compared using Chi-square test for linear trend. Standardized Incidence ratios (SIRs [95% CI]) were calculated relative to the French general population. Results: Among 44 642 patients corresponding to 180 216.4 person-years (PY), 1440 cancer cases occurred in 1314 patients. ADCs incidence was 191.4 [172.3;212.7]/105 PY and declined over time overall and in men, whereas NADCs incidence was higher (548.8 [515.6;584.1]/105 PY) and did not changed. In men, NHL was the most common cancer but prostate cancer had the highest incidence among NADCs. Breast cancer was the most common cancer in women. SIRs were higher for cervical cancer (1.93 [1.18 ; 3.14], HNC in women (2.4[1.4;4.2]), liver (overall: 3.8[3.1;4.6]; men: 3.2[2.5;4.0]; women: 12.9[8.3;20.0]), HL (overall: 13.8[11.1;17.1]; men: 16.2[12.9;20.4]; women: 6.2 [3.22;11.9]) but lower for lung (overall: 0.7[0.6;0.9]); men: 0.7 [0.5;0.8]), prostate (0.6[0.5;0.7] and breast cancer (0.6[0.4;0.7]). Conclusions: Spectrum of NADCs has changed with prostate and breast becoming the most common despite their lower SIR. Impact: These results confirm the need to maintain regular epidemiological cancer monitoring in order to update screening guidelines.