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HIV-associated anal cancer - Has highly active antiretroviral therapy reduced the incidence or improved the outcome?

Bower, M; Powles, T; Newsom-Davis, T; Thirlwell, C; Stebbing, J; Mandalia, S; Nelson, M; (2004) HIV-associated anal cancer - Has highly active antiretroviral therapy reduced the incidence or improved the outcome? JAIDS-J ACQ IMM DEF , 37 (5) 1563 - 1565.

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Abstract

Background: Highly active antiretroviral therapy (HAART) has reduced the incidence and improved the survival of patients with Kaposi sarcoma and AIDS-related non-Hodgkin lymphoma. We wished to evaluate its effects on incidence and survival in HIV-associated anal cancer.Methods: We measured the incidence and survival of patients with invasive anal cancer from our prospective cohort of 8640 HIVseropositive individuals.Results: In our cohort of 8640 HIV-seropositive individuals, the incidence of invasive anal cancer (diagnosed in 26 patients) is 60 per 100,000 patient-years. This is 120 times higher than in the age- and gender-matched general population. The incidence of invasive anal cancer in the HIV cohort was 35 (95% confidence interval Cl: 15-72) per 100,000 patient-years of follow-up in the pre-HAART era (1984-1995) and 92 (95% CI: 52-149) per 100,000 patient-years of follow-up in the post-HAART era (1996-2003) (P > 0.05). These figures are significantly higher than those for the general population (P < 0.001 for both) and give a relative risk of 67 and 176 in the pre- and post-HAART eras, respectively, compared with the general population. The 5-year overall survival is 47% (95% Cl: 24%-70%), and the 5-year disease-free survival is 66% (95% Cl: 45%-87%). There is no difference in overall survival between the pre- and post-HAART eras (log rank P = 0.19). Conclusions: Unlike other HIV-associated cancers, there has been no significant change in the incidence, clinical features, or overall survival since the introduction of HAART.

Type: Article
Title: HIV-associated anal cancer - Has highly active antiretroviral therapy reduced the incidence or improved the outcome?
Keywords: HIV, anal cancer, highly active antiretroviral therapy, incidence, HUMAN-IMMUNODEFICIENCY-VIRUS, SQUAMOUS-CELL CARCINOMA, POSITIVE PATIENTS, INFECTION, TOLERANCE, MEN
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: http://discovery.ucl.ac.uk/id/eprint/318945
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