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Survival After Cancer Diagnosis in Persons With AIDS

Biggar, Robert J MD*; Engels, Eric A MD*; Ly, Sonny MS; Kahn, Amy MS; Schymura, Maria J PhD; Sackoff, Judith PhD; Virgo, Phillip BS§; Pfeiffer, Ruth M PhD

JAIDS Journal of Acquired Immune Deficiency Syndromes: July 1st, 2005 - Volume 39 - Issue 3 - p 293-299
doi: 10.1097/01.qai.0000164033.02947.e3
Clinical Science

The survival of persons with AIDS (PWA) has recently improved because of better antiretroviral therapies. Similarly, the prognosis of cancer has also improved. To determine if survival in PWA with cancer has also improved, we compared cancer survival in adults with and without AIDS using data from New York City from 1980 through 2000. Analyses were made for AIDS-related cancers (Kaposi sarcoma, non-Hodgkin lymphoma [NHL], and cervical cancer) and for 8 non-AIDS-related cancers (lung, larynx, colorectum, anus, Hodgkin lymphoma, breast, prostate, and testis). Death hazard ratios compared survival in PWA with cancer with that in cancer patients without AIDS, adjusted for age, sex, race, and calendar-time of cancer occurrence. The 24-month survival rate of PWA with cancer (9015 AIDS cancers and 929 non-AIDS-related cancers of 8 types) improved significantly for most cancer types. By 1996 through 2000, the 24-month survival rate in PWA was 58% for Kaposi sarcoma, 41% for peripheral NHL, 29% for central nervous system NHL, and 64% for cervical cancer. For non-AIDS-related cancers, survival of PWA was lowest for lung cancer (10%) but was >50% for most other cancer types. In 1996 through 2000, significant differences in survival between cancer patients with and without AIDS still remained for Hodgkin lymphoma and lung, larynx, and prostate cancers. We conclude that recent improvements in AIDS and cancer care have greatly narrowed the gap in survival between cancer patients with and without AIDS. Clinicians should be encouraged by the improving prognosis and be diligent about detecting and treating cancer in PWA.

From the *Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, MD; †Epidemiology Program, New York City Department of Health and Mental Hygiene, New York, NY; ‡New York State Cancer Registry, New York State Department of Health, Albany, NY; §Computer Sciences Corporation, Rockville, MD; and ∥Biostatistics Branch, DCEG, NCI, NIH, DHHS, Bethesda, MD.

Received for publication November 24, 2004; accepted March 16, 2005.

The authors present this as their original work not under consideration elsewhere and have no conflict of interest with any aspect of this study.

Reprints: Robert J. Biggar, Viral Epidemiology Branch, DCEG, NCI, NIH, DHHS, 6120 Executive Boulevard, Room 8014, Bethesda, MD, 20852 (E-mail:

© 2005 Lippincott Williams & Wilkins, Inc.