Cancer Treatment Disparities in HIV-Infected Individuals in the United States – @ASCO Study

HIV-infected individuals are less likely to receive treatment for some #cancers than uninfected people, which may affect survival rates.

Abstract

ASCO logo image
HIV patients less likely to get cancer treatment in the United States.
An ASCO American Society of Clinical Oncology study

Purpose
HIV-infected individuals with cancer have worse survival rates compared with their HIV-uninfected counterparts. One explanation may be differing cancer treatment; however, few studies have examined this.

Patients and Methods
We used HIV and cancer registry data from Connecticut, Michigan, and Texas to study adults diagnosed with non-Hodgkin’s lymphoma, Hodgkin’s lymphoma, or cervical, lung, anal, prostate, colorectal, or breast cancers from 1996 to 2010. We used logistic regression to examine associations between HIV status and cancer treatment, adjusted for cancer stage and demographic covariates. For a subset of local-stage cancers, we used logistic regression to assess the relationship between HIV status and standard treatment modality. We identified predictors of cancer treatment among individuals with both HIV and cancer.

Results
We evaluated 3,045 HIV-infected patients with cancer and 1,087,648 patients with cancer without HIV infection. A significantly higher proportion of HIV-infected individuals did not receive cancer treatment for diffuse large B-cell lymphoma (DLBCL; adjusted odds ratio [aOR], 1.67; 95% CI, 1.41 to 1.99), lung cancer (aOR, 2.18; 95% CI, 1.80 to 2.64), Hodgkin’s lymphoma (aOR, 1.77; 95% CI, 1.33 to 2.37), prostate cancer (aOR, 1.79; 95% CI, 1.31 to 2.46), and colorectal cancer (aOR, 2.27; 95% CI, 1.38 to 3.72). HIV infection was associated with a lack of standard treatment modality for local-stage DLBCL (aOR, 2.02; 95% CI, 1.50 to 2.72), non–small-cell lung cancer (aOR, 2.43; 95% CI, 1.46 to 4.03), and colon cancer (aOR, 4.77; 95% CI, 1.76 to 12.96). Among HIV-infected individuals, factors independently associated with lack of cancer treatment included low CD4 count, male sex with injection drug use as mode of HIV exposure, age 45 to 64 years, black race, and distant or unknown cancer stage.

Conclusion
HIV-infected individuals are less likely to receive treatment for some cancers than uninfected people, which may affect survival rates.

Sources
  • Cancer Treatment Disparities in HIV-Infected Individuals in the United States, the American Society of Clinical Oncology, 10.1200/JCO.2013.54.8644, June 30, 2014.
  • HIV Patients Less Likely to Get Cancer Treatment: Study, News.Health, July 1, 2014.

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