Care Outcomes in People Living with HIV and Cancer

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14.•

Corrigan KL, Wall KC, Bartlett JA, Suneja G. Cancer disparities in people with HIV: A systematic review of screening for non-AIDS–defining malignancies. Cancer. 2019;12(5):843–53 This systematic review compiles findings from various studies on the screening disparities for NADCs in PLWH in high-income countries. The nine-study systematic review found inconclusive evidence on differential screening practices by HIV status, but determined that access to care, insurance status, education, and income levels were critical risk factors for poor cancer screening in PLWH.

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Shiels MS, Copeland G, Goodman MT, Harrell J, Lynch CF, Pawlish K, et al. Cancer stage at diagnosis in patients infected with the human immunodeficiency virus and transplant recipients: Cancer Stage in Immunosuppressed Patients. Cancer. 2015;121:2063–71 Using the HIV/AIDS Cancer Match study, the authors demonstrated that cancer (melanoma and bladder) was detected at more advanced stages in PLWH and they were more likely to be diagnosed with distant stage cancer (lung, breast, prostate) than immunocompetent cancer patients. PLWH had higher odds of advanced and distant stage cancers even compared to organ transplant recipients.

38.•

Rositch AF, Jiang S, Coghill AE, Suneja G, Engels EA. Disparities and determinants of cancer treatment in elderly Americans living with human immunodeficiency virus/AIDS. Clin Infect Dis [Internet]. 2018 [cited 2019 Sep 13]; Available from: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy373/4987477. This SEER-Medicare study shows reduced cancer treatment rates in PLWH, where the lowest rates were in the 65-70 age-group. The paper also highlights the direct (HIV infection) and indirect (cancer stage and comorbidities) effects on cancer treatment in PLWH. Unlike cancer screening, cancer stage, and comorbidities, it was time to treatment and HIV infection that contributed to the cancer treatment disparity in PLWH.

39.

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