Hispanics Living With HIV at Increased Risk of HPV-Related Cancers

Compared to the general Hispanic population, Hispanics living with HIV face higher risks of human papillomavirus (HPV)—related cancers, highlighting the need for increased efforts for promoting HPV vaccination among the patient population, according to a new study.

The study findings also indicate that Hispanic adults living with HIV have higher rates of cervical and penile cancer than non-Hispanic whites and non-Hispanic blacks living with the virus.

In general, cancers attributable to infections are more common among people living with HIV due to their compromised immune systems, with the patient population accounting for 40% of all cancers. HPV causes more than 5% of cancer burden worldwide and 10% of cancer burden among people living with HIV in the United States, including cancers of the cervix, vagina, vulva, anus, penis, and oropharynx.

“Among HIV-infected Hispanics, an ethnic group that included 22% of all people living with HIV in the United States in 2015, 48% of cancers are attributable to infections, whereas 41% are among non-Hispanic whites and 37% are among non-Hispanic blacks,” wrote the study researchers.

Using data from the HIV/AIDS Cancer Match Study, researchers calculated standardized incidence ratios (SIRs) to determine cancer risk in HIV-infected Hispanics and the general Hispanic population. 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) were used. Overall survival following a cancer diagnosis was calculated from the diagnosis date to death or last follow-up date.

During 864,067 person-years of follow-up among Hispanics living with HIV, there were 502 HPV-related cancer diagnoses. The most common HPV-related cancers for the patient population were cervical cancer among females (137) and anal cancer among males (218).

Compared to the general Hispanic population, Hispanics living with HIV had significantly higher rates of cancer incidence, with the greatest relative risks observed in anal cancer (SIR for women, 13.2; SIR for men, 18.7). Among women, there was also an elevated risk for cervical (SIR, 3.59), vulvar (SIR, 9.03), and vaginal cancers (SIR, 6.02). Among men, penile cancer rates were also elevated (SIR, 3.78).

Incidence rate ratios showed that among people living with HIV, Hispanic females had close to a 2-fold higher rate of cervical cancer than non-Hispanic whites but a similar rate to that of non-Hispanic blacks. There were no observed differences in vaginal and anal cancer rates, but Hispanics had lower vulvar cancer rates than non-Hispanic Whites and non-Hispanic blacks.

Among men living with HIV, penile cancer rates were elevated more than 2-fold in Hispanics compared to non-Hispanic whites. Meanwhile, anal cancer rates were lower in Hispanic males than in both non-Hispanic whites and non-Hispanic blacks.

Five-year survival was just over 50% across cancer types for HIV-infected Hispanics. “Our study did not find major differences in overall survival after an HPV-related cancer diagnosis among HIV-infected Hispanics versus non-Hispanic whites and non-Hispanic blacks with the exception of anal cancer among women, where Hispanics had better survival than non-Hispanic blacks,” noted the researchers.

Reference

Ortiz A, Engels E, Nogueras-Gonzalez G, et al. Disparities in human papillomavirus-related cancer incidence and survival among human immunodeficiency virus-infected Hispanics living in the United States [published online October 22, 2018]. Cancer. doi: 10.1002/cncr.31702.