As HIV becomes a lifetime disease instead of a killer, researchers say these patients will likely start to mirror other Americans when it comes to the kinds of cancers they develop.
By 2030, the total number of cancers in HIV-positive people is expected to decline dramatically, as fewer patients develop tumors linked to a ravaged immune system, the new report suggested.
Prostate, lung and liver cancer are predicted to become the most common cancers in this group, followed by anal cancer, which is linked to the sexually transmitted human papillomavirus (HPV).
“They’re starting to look more like people without HIV in a lot of ways, but the cancer risk will still be different,” said Michael Silverberg, a research scientist with Kaiser Permanente Northern California. He was not involved in the study.
In the early years of the AIDS epidemic, patients developed cancers such as Kaposi sarcoma and non-Hodgkin lymphoma as their immune systems deteriorated, the researchers explained. But medical advances over the past two decades have allowed people with HIV and AIDS to live much longer.
In the new study, Jessica Islam, a graduate student at the University of North Carolina at Chapel Hill, and colleagues sought to understand how cancer might affect people with HIV through 2030.
The researchers estimated that almost 8,000 cases of cancer were diagnosed in 2010 in people with HIV: 2,720 were immune-related cancers that are common in AIDS patients, and almost 5,200 were other types of cancer.
By 2030, the researchers predict, the number of cancer cases overall will dip to about 6,500, with an especially large decrease (to 710 cases) in the number of AIDS-related cancers. Cases of Kaposi sarcoma are expected to drop but still remain higher than normal in HIV-positive people, Islam said, while non-Hodgkin lymphoma and cervical cancer rates are expected to reach normal levels in some age groups.
Meanwhile, cases of other types of cancer are expected to grow a bit, to almost 5,800 cases.
“The aging of the HIV-positive population will result in certain cancers occurring more frequently,” Islam said. “For example, as more HIV-positive men reach an age where prostate cancer becomes more common, the number of cases diagnosed will rise in that population.”
As for anal cancer, it should remain common in HIV-positive people because it’s linked to HPV, which can be sexually transmitted, Islam explained.
Silverberg said the study findings reflect what physicians and patients have noticed: “They’re seeing the typical HIV cancers on the decline, but more of the ones that you expect to see with older age.”
Although anti-HIV drugs are effective, the cancers linked to HIV will not necessarily disappear, Silverberg said. That’s because some HIV-positive people don’t know they’re infected, and their immune systems may deteriorate before they are diagnosed and treated, he added.
Dr. Gita Suneja, an associate professor with Duke University who’s studied HIV and cancer, cautioned that HIV-infected people face cancer-related challenges, regardless of the changing statistics.
“Other studies have shown that people with HIV present with more advanced-stage cancer, are less likely to receive appropriate cancer treatment, and have worse cancer survival compared to uninfected patients,” she said. “These important disparities need to be recognized.”
The study was scheduled for presentation Wednesday at the American Association for Cancer Research annual meeting, in Washington, D.C. Research released at conferences should be considered preliminary until published in a peer-reviewed journal.
For more about HIV and cancer, visit the U.S. National Cancer Institute.