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Incidence of Cancer in Women with or at Risk for HIV R. PHELPS*1‚2, D. K. SMITH1, L. GARDNER1, C. J. CARPENTER3, R. KLEIN4, D. JAMIESON1, D. VLAHOV5, P. SCHUMAN6, and S. HOLMBERG1.
1CDC, Atlanta, GA; 2Nova Res. Co., Bethesda, MD; 3Brown Univ., Providence, RI; 4Montefiore, Bronx, NY; 5New York Academy of Med., NY; 6Wayne State Univ., Detroit, MI Objective: To identify the types and rate of malignancies seen in high-risk HIV-infected and uninfected women in a prospective cohort study.
Methods: From 1993 to 1999, 871 infected and 439 uninfected women were followed at four urban US research sites with biannual visits and interviewed to identify interval diagnoses and hospitalizations. Cancer incidence data were collected through abstraction of medical records and death certificates.
Results: HIV-infected women had 24 cancers, including 7 non-Hodgkin's lymphomas (3 CNN, 2 primary lung, 2 other), 5 invasive cervical cancers (ICC) and 4 lung cancers. Among the HIV-uninfected women, 2 ductal carcinomas-in-situ of the breast, 1 carcinoma of the uvula and 1 lung cancer in a 58-year-old occurred. 85% of the women were recent/current smokers and 50% had used injection drugs. Lung cancer presented in smokers with a median age of 43 and all survived less than 6 months after cancer diagnosis. Median survival of women with lymphoma was less than 1 month from cancer diagnosis. CD4+ cell counts were above 200/mm3 in all women with ICC. Rate of ICC was 1.44/1000 person-years. We observed twice the rate of lung cancer (l.15/1000 person-years vs. 0.5/1000 person years) compared to the uninfected women.
Conclusions: Appropriate screening and follow-up of HIV-infected women for cervical dysplasia is emphasized. Lung cancer, other smoking related cancers and pulmonary lymphoma should be considered in symptomatic HIV-infected women.
Key Words: cancer, epidemiology, women
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