The risk for esophageal and stomach carcinomas, as well as non-Hodgkin lymphomas (NHLs), is significantly increased in people with AIDS, although the incidence of lymphomas has decreased, the results of a US and UK study reveal.
E Christina Persson, from the National Cancer Institute, in Rockville, Maryland, USA, and colleagues note: "The risks of these cancers, while elevated, are likely not high enough to justify cost-effective screening of the overall HIV population."
But they add: "In the clinical setting, additional efforts to implement tobacco cessation and moderation of alcohol use may have an effect in reducing the occurrence of esophageal and stomach carcinomas."
Examining data for the period 1980 to 2007 from the HIV/AIDS Cancer Match Study for 596,955 people with AIDS, the team found that people with AIDS had an increased incidence of esophageal carcinoma, at a standardized incidence ratio (SIR) of 1.69, compared with the general population. The risk was elevated for both esophageal adenocarcinoma and squamous cell carcinoma, at SIRs of 1.91 and 1.47, respectively.
The incidence of stomach carcinoma was also increased for patients with AIDS, at an SIR of 1.44, including all types of adenocarcinoma. The incidence was increased in both cardia and noncardia anatomic sites, although the SIR was significantly increased only for noncardia stomach carcinoma, at 1.53.
The team also reports in Gastroenterology that the SIRs for NHLs of the esophagus and stomach were significantly increased in people with AIDS, at 261.0 and 35.5, respectively. Although the number of cases was small, the incidence of gastric mucosa-associated lymphoid tissue lymphoma was increased, at an SIR of 5.99.
It was observed that, compared with non-Hispanic White individuals, Hispanics had a lower risk for esophageal carcinoma, while non-Hispanic Black and Hispanic individuals had an increased risk for stomach cancer, at relative risks of 0.43, 1.75, and 1.82, respectively.
The crude incidence rates of esophageal and stomach carcinomas remained stable over the study period. However, the incidence of NHLs in both the esophagus and stomach decreased significantly after the introduction of highly active antiretroviral therapy in 1996.
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