Rates of most types of cancer are falling or stable among people living with HIV, but malignancies linked to human papillomavirus (HPV) and viral hepatitis remain a concern, according to an analysis of nearly 850,000 people with HIV from 2001 to 2019 in the HIV/AIDS Cancer Match Study.

 

Opportunistic cancers related to immune suppression, such as Kaposi sarcoma, continue to decline thanks to effective antiretroviral treatment. Some of the most common malignancies—including breast, prostate and colon cancers—declined or stayed about the same among both HIV-positive and HIV-negative people, so comparative rates did not change. Studies have found that people with HIV are not at greater risk for these malignancies, and HIV-positive men may actually be less likely to develop prostate cancer.

 

Rates of lung cancer and liver cancer (which can be caused by hepatitis B or C) declined by 17% and 25%, respectively, but people with HIV were still nearly twice as likely to have liver cancer as their HIV-negative peers. There was “less clear progress” in reducing incidence of HPV-related cancers. While cervical and anal cancer rates remained stable, HIV-positive people were 17 times more likely to have anal cancer and 11 times more likely to have cancer of the vulva than their HIV-negative counterparts.

 

“These estimates may provide insight into the priorities for prevention and early detection of cancer as the population of people with HIV enters ages with greater risk for cancer,” Meredith Shiels, PhD, of the National Cancer Institute, and colleagues concluded.