Cancer survival in people with AIDS

A population-based study from São Paulo, Brazil

Luana F. Tanaka, Maria do Rosário D.O. Latorre, Eliana B. Gutierrez, Maria P. Curado, Luigino Dal Maso, Karl Heinz Herbinger, Guenter Froeschl, Christian Heumann

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Cancer survival among people with AIDS (PWA) has been described in developed countries, but there is lack of data from developing countries. The aim of this study was to evaluate survival after cancer diagnosis in PWA and compare it with people without AIDS (non-PWA) in São Paulo, Brazil. A probabilistic record linkage was carried out between the databases of the Population-based Cancer Registry of São Paulo (PBCR-SP) and the AIDS registry of SP (SINAN) to identify PWA who developed cancer. For comparison, non-PWA were frequency matched from the PBCR-SP by cancer site/type, sex, age, and period. Hazard ratio (HR) stratified by matching variables was estimated using a Cox proportional hazards model. A total of 1,294 PWA (20 patients with two primary site tumors) were included in the site/type-specific analyses. AIDS-defining cancers (ADC) comprised 51.9% of cases assessed. The all-cancer 5-year overall survival in PWA was 49.4% versus 72.7% in non-PWA (HR = 2.64; 95%CI = 2.39–2.91). Survival was impaired in PWA for both ADC (HR = 2.93; 95%CI = 2.49–3.45) and non-ADC (HR = 2.51; 95%CI = 2.21–2.84), including bladder (HR = 8.11; 95% CI = 2.09–31.52), lung (HR = 2.93; 95%CI = 1.97–4.36) and anal cancer (HR = 2.53; 95%CI = 1.63–3.94). These disparities were seen mainly in the first year after cancer diagnosis. The overall survival was significantly lower in PWA in comparison with non-PWA in São Paulo, as seen in high-income countries. Efforts to enhance early diagnosis and ensure proper cancer treatment in PWA should be emphasized.

Original languageEnglish
Pages (from-to)524-533
Number of pages10
JournalInternational Journal of Cancer
Volume142
Issue number3
DOIs
Publication statusPublished - Feb 1 2018

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Brazil
Acquired Immunodeficiency Syndrome
Survival
Population
Neoplasms
Registries
Anus Neoplasms
Proportional Hazards Models
Developed Countries
Developing Countries
Early Diagnosis
Urinary Bladder
Databases

Keywords

  • cancer
  • epidemiology
  • HIV/AIDS
  • medical record linkage
  • survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Tanaka, L. F., Latorre, M. D. R. D. O., Gutierrez, E. B., Curado, M. P., Dal Maso, L., Herbinger, K. H., ... Heumann, C. (2018). Cancer survival in people with AIDS: A population-based study from São Paulo, Brazil. International Journal of Cancer, 142(3), 524-533. https://doi.org/10.1002/ijc.31081

Cancer survival in people with AIDS : A population-based study from São Paulo, Brazil. / Tanaka, Luana F.; Latorre, Maria do Rosário D.O.; Gutierrez, Eliana B.; Curado, Maria P.; Dal Maso, Luigino; Herbinger, Karl Heinz; Froeschl, Guenter; Heumann, Christian.

In: International Journal of Cancer, Vol. 142, No. 3, 01.02.2018, p. 524-533.

Research output: Contribution to journalArticle

Tanaka, LF, Latorre, MDRDO, Gutierrez, EB, Curado, MP, Dal Maso, L, Herbinger, KH, Froeschl, G & Heumann, C 2018, 'Cancer survival in people with AIDS: A population-based study from São Paulo, Brazil', International Journal of Cancer, vol. 142, no. 3, pp. 524-533. https://doi.org/10.1002/ijc.31081
Tanaka, Luana F. ; Latorre, Maria do Rosário D.O. ; Gutierrez, Eliana B. ; Curado, Maria P. ; Dal Maso, Luigino ; Herbinger, Karl Heinz ; Froeschl, Guenter ; Heumann, Christian. / Cancer survival in people with AIDS : A population-based study from São Paulo, Brazil. In: International Journal of Cancer. 2018 ; Vol. 142, No. 3. pp. 524-533.
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abstract = "Cancer survival among people with AIDS (PWA) has been described in developed countries, but there is lack of data from developing countries. The aim of this study was to evaluate survival after cancer diagnosis in PWA and compare it with people without AIDS (non-PWA) in S{\~a}o Paulo, Brazil. A probabilistic record linkage was carried out between the databases of the Population-based Cancer Registry of S{\~a}o Paulo (PBCR-SP) and the AIDS registry of SP (SINAN) to identify PWA who developed cancer. For comparison, non-PWA were frequency matched from the PBCR-SP by cancer site/type, sex, age, and period. Hazard ratio (HR) stratified by matching variables was estimated using a Cox proportional hazards model. A total of 1,294 PWA (20 patients with two primary site tumors) were included in the site/type-specific analyses. AIDS-defining cancers (ADC) comprised 51.9{\%} of cases assessed. The all-cancer 5-year overall survival in PWA was 49.4{\%} versus 72.7{\%} in non-PWA (HR = 2.64; 95{\%}CI = 2.39–2.91). Survival was impaired in PWA for both ADC (HR = 2.93; 95{\%}CI = 2.49–3.45) and non-ADC (HR = 2.51; 95{\%}CI = 2.21–2.84), including bladder (HR = 8.11; 95{\%} CI = 2.09–31.52), lung (HR = 2.93; 95{\%}CI = 1.97–4.36) and anal cancer (HR = 2.53; 95{\%}CI = 1.63–3.94). These disparities were seen mainly in the first year after cancer diagnosis. The overall survival was significantly lower in PWA in comparison with non-PWA in S{\~a}o Paulo, as seen in high-income countries. Efforts to enhance early diagnosis and ensure proper cancer treatment in PWA should be emphasized.",
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