Cancer burden attributable to cigarette smoking among HIV-infected people in North America

被引：42

作者：

Altekruse, Sean F. ^{[1
]}

Shiels, Meredith S. ^{[2
]}

Modur, Sharada P. ^{[3
]}

Land, Stephanie R. ^{[1
]}

Crothers, Kristina A. ^{[4
]}

Kitahata, Mari M. ^{[4
]}

Thorne, Jennifer E. ^{[5
]}

Mathews, William C. ^{[6
]}

Fernandez-Santos, Diana M. ^{[7
]}

Mayor, Angel M. ^{[7
]}

Gill, John M. ^{[8
]}

Horberg, Michael A. ^{[9
]}

Brooks, John T. ^{[10
]}

Moore, Richard D. ^{[5
]}

Silverberg, Michael J. ^{[11
]}

Althoff, Keri N. ^{[3
]}

Engels, Eric A. ^{[2
]}

机构：

[1] NCI, Div Canc Control & Populat Sci, Bethesda, MD 20892 USA

[2] NCI, Div Canc Epidemiol & Genet, Bethesda, MD 20892 USA

[3] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA

[4] Univ Washington, Sch Med, Seattle, WA USA

[5] Johns Hopkins Med Inst, Baltimore, MD 21205 USA

[6] Univ Calif San Diego Hlth Syst, San Diego, CA USA

[7] Univ Cent Caribe Sch Med, Bayamon, PR USA

[8] Alberta Hlth Serv, Calgary, AB, Canada

[9] Kaiser Permanente Div Res, Rockville, MD USA

[10] Ctr Dis Control & Prevent, Atlanta, GA USA

[11] Kaiser Permanente Div Res, Oakland, CA USA

来源：

AIDS | 2018年 / 32卷 / 04期

基金：

美国医疗保健研究与质量局; 美国国家卫生研究院; 加拿大健康研究院;

关键词：

attributable risk; cancer; HIV; North America; smoking; IMMUNODEFICIENCY-VIRUS-INFECTION; ANTIRETROVIRAL THERAPY; RISK-FACTORS; CARDIOVASCULAR-DISEASE; COHORT COLLABORATION; UNITED-STATES; LUNG-CANCER; POPULATION; AIDS; MORTALITY;

D O I：

10.1097/QAD.0000000000001721

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Objective: With combination-antiretroviral therapy, HIV-infected individuals live longer with an elevated burden of cancer. Given the high prevalence of smoking among HIV-infected populations, we examined the risk of incident cancers attributable to ever smoking cigarettes. Design: Observational cohort of HIV-infected participants with 270 136 person-years of follow-up in the North American AIDS Cohort Collaboration on Research and Design consortium. Among 52 441 participants, 2306 were diagnosed with cancer during 2000-2015. Main outcome measures: Estimated hazard ratios and population-attributable fractions (PAF) associated with ever cigarette smoking for all cancers combined, smoking-related cancers, and cancers that were not attributed to smoking. Results: People with cancer were more frequently ever smokers (79%) compared with people without cancer (73%). Adjusting for demographic and clinical factors, cigarette smoking was associated with increased risk of cancer overall [hazard ratios = 1.33 (95% confidence interval: 1.18-1.49)]; smoking-related cancers [hazard ratios = 2.31 (1.80-2.98)]; lung cancer [hazard ratios = 17.80 (5.60-56.63)]; but not nonsmoking-related cancers [hazard ratios = 1.12 (0.98-1.28)]. Adjusted PAFs associated with ever cigarette smoking were as follows: all cancers combined, PAF = 19% (95% confidence interval: 13-25%); smoking-related cancers, PAF = 50% (39-59%); lung cancer, PAF = 94% (82-98%); and nonsmoking-related cancers, PAF = 9% (1-16%). Conclusion: Among HIV-infected persons, approximately one-fifth of all incident cancer, including half of smoking-related cancer, and 94% of lung cancer diagnoses could potentially be prevented by eliminating cigarette smoking. Cigarette smoking could contribute to some cancers that were classified as nonsmoking-related cancers in this report. Enhanced smoking cessation efforts targeted to HIV-infected individuals are needed. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.

引用

页码：513 / 521

页数：9

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