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HIV Infection Tied To Elevated Lung Cancer Risk

NEW YORK APR 14, 2006 (Reuters Health) - Even after adjusting for smoking, HIV-infected patients appear to be at increased risk for lung cancer, according to a report in the March issue of the Journal of Clinical Oncology. Moreover, the extent of immunosuppression seems to have no bearing on the risk.

The findings "suggest that smoking might not entirely explain the excess of lung cancer among HIV-infected persons, pointing to a need for research regarding the pathogenesis of lung cancer in this setting," Dr. Eric A. Engels, from the National Cancer Institute in Bethesda, Maryland, and colleagues state.

The results are based on an analysis of data for 5238 HIV-infected patients who attended an HIV specialty clinic in Baltimore between 1989 and 2003. Lung cancer rates in this group were compared with that seen in an urban reference population.

Thiry-three lung cancers occurred in the study group, yielding an incidence of 170 per 100,000 person-years. Increasing age was identified as a risk factor for lung cancer, but gender, race, and CD4+ count seemed to have no effect.

Nonsignificant increases in lung cancer incidence were seen with calendar year and HAART use. Lung cancer incidence was inversely linked to HIV viral load, but the association lost its statistical significance after adjustment for age.

The standardized incidence ratio in the study cohort versus the general population was 4.7, the report indicates. After adjustment for smoking, which was reported by 69% of the cohort, the standardized incidence ratio fell to 2.5.

"As people with HIV infection live longer and age, lung cancer will likely grow in importance as a cause of morbidity and mortality," the authors state. "Clinicians should be alert to the possible diagnosis of lung cancer in HIV-infected patients."


J Clin Oncol 2006;24:1383-1388.

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