A new study reveals that Hispanic HIV-infected adults in the United States are at a higher risk of developing cancers caused by the human papillomavirus (HPV) than Hispanics from the general population. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings highlight the need for continued efforts to develop and implement appropriate HPV-vaccination and cancer screening programs for individuals with HIV, and for additional research that explains the causes of racial/ethnic disparities in HPV-related cancer occurrences.
HPV causes 10 percent of cancers among HIV-infected people in the United States. Because Hispanics are disproportionately impacted by the HIV epidemic, as well as by infection-related cancers, Ana Patricia Ortiz, Ph.D., of the University of Puerto Rico Comprehensive Cancer Center in San Juan, and her colleagues compared incidence rates of HPV-related cancers among Hispanics with rates among non-Hispanic whites and non-Hispanic Blacks in the HIV-infected U.S. population. The researchers also examined survival rates in affected patients.
The study included information from the HIV/AIDS Cancer Match Study that was collected by U.S. HIV and cancer registries from Colorado (1996-2007), Connecticut (2005-2010), Georgia (2004-2012), Maryland (2008-2012), Michigan (1996-2010), New Jersey (1996-2012), New York (2001-2012), Puerto Rico (2003-2012), and Texas (1999-2009).
The investigators found that 502 HPV-related cancers occurred in 864,067 person-years of follow-up among HIV-infected Hispanics. The most common HPV-related cancers among HIV-infected Hispanics were cervical cancer among women, with an incidence rate of 56 cases per 100,000 women, and anal cancer among men, with an incidence rate of 35.2 per 100,000 men. These were also the most common HPV-related cancers in HIV-infected non-Hispanic whites and non-Hispanic Blacks.
Among HIV-infected females, Hispanics had a 70 percent higher incidence rate of cervical cancer than non-Hispanic whites, but they had lower rates of vulvar cancer. Among HIV-infected males, Hispanics had a 2.6-times higher incidence rate of penile cancers than non-Hispanic whites, but they had lower anal cancer rates. Hispanics also had lower risks of vulvar and anal cancer than non-Hispanic Black women and men, respectively, although no significant differences were observed between these two racial/ethnic groups with respect to the other cancer types evaluated. Among HIV-infected individuals, approximately half of patients across all HPV-related cancer types survived at least 5 years, with no major differences by race/ethnic group.
"This is the first assessment of HPV-related cancer burden in HIV-infected Hispanics that considers Hispanics living in the continental U.S. and in Puerto Rico. Our findings show that similar to what is observed among other racial/ethnic groups in the U.S., HIV-infected Hispanics have elevated rates of most HPV-related malignancies as compared to Hispanics from the general population," said Dr. Ortiz. "The highest excess risk was observed for anal cancer, highlighting the importance of continued efforts to develop and implement appropriate anal cancer screening for HIV-infected adults. Our study also evidenced that similar to what is observed in the general population, HIV-infected Hispanics have higher rates of cervical and penile cancer than non-Hispanic whites and non-Hispanic Blacks."
Dr. Ortiz noted that although racial/ethnic disparities in cancer rates among HIV-infected individuals may reflect disparities in the general population, the causes of these disparities warrant further research, as patterns are not consistent across cancer sites.
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"Disparities in HPV-related cancer incidence and survival among HIV-infected Hispanics living in the United States." CANCER (2018). DOI: 10.1002/cncr.31702