Trends in survival after cancer diagnosis among HIV‐infected individuals between 1992 and 2009. Results from the FHDH‐ANRS CO4 cohort |
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| Authors: | Mira Hleyhel Aurlien Belot Anne‐Marie Bouvier Pierre Tattevin Jrme Pacanowski Philippe Genet Nathalie De Castro Jean‐Luc Berger Caroline Dupont Armelle Lavol Christian Pradier Dominique Salmon Anne Simon Valrie Martinez Jean‐Philippe Spano Dominique Costagliola Sophie Grabar |
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| Institution: | 1. INSERM, UMR_S 1136, Institut Pierre Louis D'epidémiologie Et De Santé Publique, Paris, France;2. Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis D'epidémiologie Et De Santé Publique, Paris, France;3. Hospices Civils De Lyon, Service De Biostatistique, Lyon, France;4. Département Des Maladies Chroniques Et Traumatismes, Institut De Veille Sanitaire, Saint‐Maurice, France;5. CNRS UMR 5558, Laboratoire De Biométrie Et Biologie évolutive, Equipe Biostatistique‐Santé, Villeurbanne, France;6. Department of Non‐Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Cancer Research UK Cancer Survival Group, Faculty of Epidemiology and Population Health, London, United Kingdom;7. INSERM UMR 866, Registre Bourguignon Des Cancers Digestifs, FRANCIM, Centre Hospitalier Universitaire (CHU) De Dijon, Dijon, France;8. CHU De Rennes, H?pital Pontchaillou, Service De Maladies Infectieuses, Rennes, France;9. Assistance Publique H?pitaux De Paris (AP‐HP), H?pital Saint Antoine, Service De Maladies Infectieuses Et Tropicales, Paris, France;10. Centre Hospitalier D'argenteuil, Service d'hématologie‐SIDA, Argenteuil, France;11. AP‐HP, H?pital Saint Louis, Service De Maladies Infectieuses Et Tropicales, Paris, France;12. CHU De Reims, Service De Médecine Interne Et De Pathologie Infectieuse, Reims, France;13. AP‐HP, H?pital Ambroise‐Paré, Service De Médecine Interne, Boulogne, France;14. AP‐HP, H?pital Tenon, Service De Pneumologie, Paris, France;15. Département De Santé Publique, CHU De Nice, H?pital De L'archet, Nice, France;16. AP‐HP, Groupe Hospitalier Cochin Broca H?tel‐Dieu, Service De Médecine Interne Et Centre De Référence Maladies Rares, Paris, France;17. Sorbonne Universités, Université Paris Descartes, Paris, France;18. AP‐HP, Groupe Hospitalier Pitié‐Salpêtrière, Service De Médecine Interne, Paris, France;19. AP‐HP, H?pital Antoine Béclère, Service De Médecine Interne—Immunologie Clinique, Clamart, France;20. AP‐HP, Groupe Hospitalier Pitié‐Salpêtrière, Service D'oncologie Médicale, IUC, Paris, France |
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| Abstract: | Although the decline in cancer mortality rates with the advent of combination antiretroviral therapy (cART) in HIV‐infected individuals can be mostly explained by a decrease in cancers incidence, we looked here if improved survival after cancer diagnosis could also contribute to this decline. Survival trends were analyzed for most frequent cancers in the HIV‐infected population followed in the French Hospital Database on HIV: 979 and 2,760 cases of visceral and non‐visceral Kaposi's sarcoma (KS), 2,339 and 461 cases of non‐Hodgkin lymphoma (NHL) and Hodgkin's lymphoma (HL), 446 lung, 312 liver and 257 anal cancers. Five‐year Kaplan–Meier survival rates were estimated for four periods: 1992–1996, 1997–2000, 2001–2004 and 2005–2009. Cox proportional hazard models were used to compare survival across the periods, after adjustment for confounding factors. For 2001–2004, survival was compared to the general population after standardization on age and sex. Between the pre‐cART (1992–1996) and early‐cART (1997–2000) periods, survival improved after KS, NHL, HL and anal cancer and remained stable after lung and liver cancers. During the cART era, 5‐year survival improved after visceral and non‐visceral KS, NHL, HL and liver cancer, being 83, 92, 65, 87 and 19% in 2005–2009, respectively, and remained stable after lung and anal cancers, being 16 and 65%, respectively. Compared with the general population, survival in HIV‐infected individuals in 2001–2004 was poorer for hematological malignancies and similar for solid tumors. For hematological malignancies, survival continues to improve after 2004, suggesting that the gap between the HIV‐infected and general populations will close in the future. |
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| Keywords: | survival cancer HIV calendar period general population |
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