Elevated risk for squamous cell carcinoma of the conjunctiva among adults with AIDS in the United States

Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD 20852, USA.
International Journal of Cancer (Impact Factor: 5.09). 06/2008; 122(11):2590-3. DOI: 10.1002/ijc.23384
Source: PubMed


Squamous cell carcinoma of the conjunctiva (SCCC) has been associated with HIV infection in equatorial Africa, but the evidence for association with HIV in developed countries, where SCCC is rarer, is controversial. We investigated the risk for SCCC and other eye cancers in the updated U.S. HIV/AIDS Cancer Match Registry Study. We calculated standardized incidence ratios (SIRs) to estimate excess risk for SCCC, primary ocular lymphoma, ocular Kaposi sarcoma (KS) and other eye tumors among 491, 048 adults (aged > 15 years or older) with HIV/AIDS diagnosed from 1980 to 2004. We calculated relative proportions (per 10(5)) to gain insight into risk factors. We identified 73 eye cancers (15 SCCC, 35 primary ocular lymphoma, 17 ocular KS and 6 other). Overall SIRs were elevated for SCCC (SIR, 12.2, 95% CI 6.8-20.2), primary ocular lymphoma (21.7, 95% CI 15.1-30.2) and ocular KS (109, 95% CI 63.5-175). Risk for SCCC was elevated regardless of HIV acquisition category, CD4 lymphocyte count and time relative to AIDS-onset. Relative proportions of SCCC risk were highest with age >or=50 (8/10(5)), Hispanic ethnicity (7/10(5)) and residence in regions with high-solar ultraviolet radiation (10/10(5)). We show significantly increased incidence of SCCC among persons with HIV/AIDS in the U.S. The associations with age and geography are in accord with etiological role for ultraviolet radiation in SCCC.

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Available from: Sam Mbulaiteye, Nov 12, 2014
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    • "The subtype of HIV involved was seldom available (Newton et al, 2002). With the exception of the two studies conducted in the United States (Goedert and Cote, 1995; Guech-Ongey et al, 2008), all were case–control analyses. Only three studies provided RR estimates adjusted for potential confounders (Newton et al, 2002; Guech-Ongey et al, 2008; Ateenyi-Agaba et al, 2010), mostly age and sex. "
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    • "[44]. In a recent publication, using data from the same registry study, Guech-Onguey et al confirmed this association (SIR 12.2 (95% CI 6.8–20.2)) in HIV-infected people [63]. "
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    • "Some tumors are observed more frequently in PHA because of lifestyles that expose PHA to specific carcinogens, such as lung cancer related to the high frequency of smoking in PHA [8]. A few otherwise rare tumors, such as squamous cell carcinoma of the conjunctiva [9,10] and Merkel cell carcinoma of the skin [11], also appear to be increased. Other tumors have been reported to have marginal or inconsistent increases in PHA, and their associations with level of HIV/AIDS immunosuppression are still controversial. "
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