HIV infection associated with worse prostate cancer outcomes
medwireNews: Older individuals with HIV and prostate cancer have worse outcomes than corresponding cancer patients without HIV, according to a large database study from the USA.
This is the case despite both groups of patients “receiving similar stage-appropriate cancer treatment,” say Anna Coghill (H Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA) and colleagues in JAMA Oncology.
The researchers used the SEER–Medicare linked database to identify patients aged 65 years and older with local or regional stage cancer who received stage-appropriate treatment in the first year after their cancer diagnosis and survived for at least a year.
They looked at the association between HIV status and mortality adjusting for patient age, sex, race/ethnicity, year of cancer diagnosis, median income, and treatment specifics among 288 HIV-infected and 307,980 HIV-uninfected patients. Prostate cancer was the most represented group, affecting 170 HIV-infected and 133,016 HIV-uninfected men.
HIV-infected men with prostate cancer had a significant 1.58-fold increased risk for overall mortality and a nonsignificant 1.65-fold increased risk for cancer-specific mortality compared with their HIV-uninfected counterparts. In addition, those who survived for at least 15 months after their cancer diagnosis had a significant 1.32-fold increased risk for relapse or death. This was despite delivered treatments being largely similar for the HIV-infected and -uninfected populations, as would be expected by the study’s inclusion criteria.
No such differences were seen among the 34 HIV-infected and 29,217 HIV-uninfected individuals with non-small-cell lung cancer, however, in which rates of overall and cancer-specific mortality were similar between the two groups.
Commenting on the findings, the researchers note: “People living with HIV are expected to die at higher overall rates due to the contribution of AIDS-related comorbidities, but we report that HIV-infected patients with cancer who are 65 years or older are also at increased risk of cancer-specific death and relapse after initial therapy.”
They conclude: “As the HIV population continues to age, the association of HIV infection with poor […] prostate cancer outcomes will become increasingly relevant, especially because prostate cancer is projected to become the most common malignant neoplasm in the HIV population in the United States by 2030.
“Research on clinical strategies to improve outcomes in HIV-infected patients with cancer is warranted.”
By Catherine Booth
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