The Trends and Risk Factors of AIDS-Defining Cancers and Non-AIDS-Defining Cancers in Adults Living with and without HIV: A Narrative Review

Table 1

Characteristics of the included studies reporting cancer incidence and mortality.

Author & year	Study population		Study setting	Study design	Study period	Key findings
						ADC studied	Most common ADC	NADC studied	Most common NADC	Mortality assessed
	Population type	Gender (those with cancer)
Kauma et al., 2023 [40]	167 PLHIV & also with cancer	Female (58.1%); Male (41.9%)	Uganda (LIC)	Cross-sectional	2018-2019	Cervical, KS, and NHL	Cervical	Head & neck, esophageal, breast, & others	Breast	No
Muturi et al., 2023 [41]	301 with cancer, 32 (10.6%) PLHIV, and 269 (89.4%) HIV negative	Female (67.8%) Male (32.2%)	Kenya (LMIC)	Cross-sectional	2021	Cervical, KS, and NHL	Cervical	Prostate, lung, gastric, gall bladder, HL breast, tongue, larynx, anal, and head & neck	Breast	No
Arora et al., 2021 [42]	1258 PLHIV and 17 (1.4%) with cancer	Female (41.2%); Male (58.8%)	India (LMIC)	Retrospective & prospective cohorts	2011-2018	NHL, KS, and invasive cervical cancer	NHL	Lung, leukemia, breast, tongue, larynx, HL, and anal	HL	(i) Mortality rates were similar in both ADCs and NADCs; (ii) Mean survival duration was 29 and 15 months for ADC and NADC, respectively
Horner et al., 2021 [43]	521623 PLHIV and 31611 (6.1%) with cancer	Gender not specified	USA (HIC)	Retrospective cohort	2001-2015	Cervical, KS, and NHL	NHL	Anus, liver, HL, breast, prostate, lung, & colorectal	Lung	Mortality rate was 386.9 & highest in males (401.4) versus 348.1 in females; (i) Leading with high cancer-attributable mortality rates were NHL (92.6) and lung (63.0); (ii) Cancer-attributable mortality was highest among those years; (iii) Mortality declined by years: 484/100000 PY in 2001-2005 to 313.6/100000 PY in 2011-2015
Mendoza et al., 2021 [44]	269 PLHIV & also with cancer (276 cancers)	Female (20.7%); Male (79.3%),	Peru (UMIC)	Cross-sectional	2000-2018	KS, NHL, & invasive cervical cancer	KS	HL, skin, & cervical cancer in situ	HL	No
Patel et al., 2021 [45]	6641 PLHIV and 543 (8.2%) with cancer	Female (21.7%); Male (78.7%)	USA (HIC)	Retrospective cohort	2005-2011	Cervical, KS, and NHL	NHL	Colorectal, lung, anal, renal pelvis, liver, prostate, HL multiple myeloma, bladder, & breast	Colorectal	No
Spence et al., 2021 [46]	7912 PLHIV and 706 (8.9%) with cancer	Female (19.7%); Male (80.3%)	USA (HIC)	Longitudinal observational cohort	2011-2017	NHL, cervical, and KS	NHL	Breast, prostate, skin, melanoma, lung, nonmelanoma, anal, liver, head/neck, colorectal, HL, & renal	Breast	No
Wang et al., 2021 [47]	438 PLHIV & also with cancer	Female (19%); Male (81%)	China (UMIC)	Retrospective cohort	2007-2020	NHL, KS, and cervical	NHL	Lung, thyroid, gastric, breast hepatic, rectal carcinoma, leukemia, lymphoma, & others	Lung	No
Altuntas et al., 2020 [48]	1872 PLHIV and 48 (2.6%) with cancer	Female (8.3%); Male (91.7%)	Turkey (UMIC)	Retrospective cohort	1998-2016	KS and NHL	KS	Gastrointestinal, urogenital, lung, laryngeal, & spinal cord	Not specified	More NADC deaths (53.8%) compared to ADC deaths (22.9%)
Calkins et al., 2020 [49]	236 PLHIV & also with cancer	Female (31%); Male (69%)	USA (HIC)	Retrospective cohort	1997-2014	NHL (the only ADC)	NHL	Lung, liver, HL, prostate, & breast	Lung	(i) Among 138 HIV-infected who died, 74% was attributed to cancer; (ii) The HIV-infected with baseline had on average a 7-month shorter survival after cancer diagnosis than those HIV negative; (iii) Women with HIV and had on average a 10-month shorter survival than women without HIV
Gheorghiță et al., 2019 [50]	110 PLHIV & also with cancer	Female (43.6%); Male (56.4%)	Romania (UMIC)	Observational & retrospective cohort	2010-2016	KS, NHL, & cervical	KS	Breast, colorectal, HL, anal, hepatocellular, bronchopulmonary, gastric, & others	Digestive & anal	Cumulative mortality is 15.9 for ADCs and 19.5 for NADCs with NHL leading ADC-related deaths
Sinha et al., 2019 [51]	999 PLHIV and 29 (2.9%) with cancer	Female (24.1%); Male (75.9%)	India (LMIC)	Cross-sectional	2013-2016	NHL & invasive cervical	NHL	HL, lung, gall bladder, skin, nasal, & colon	HL	No
Billa et al., 2018 [52]	1391 PLHIV & HCV coinfection and 94 (6.8%) with cancer	Gender not specified	France (HIC)	Prospective cohort	2005-2017	Individual ADCs not specified	Not specified	Lung & nonmelanin skin, non-hepatitis C virus liver-related cancers, & hepatitis C virus-related	Lung	No
Cornejo-Juarez et al., 2018 [53]	1126 PLHIV and 127 (11.3%) with cancer (NADCs only)	Female (20.5%); Male (79.5%)	Mexico (UMIC)	Observational & retrospective cohort	1990-2016	No	N/A	HL, anal, germinal, vulvovaginal, breast, & others	HL & vulvovaginal	High proportion of deaths were in germinal cancer, all died
Fink et al., 2018 [54]	15869 PLHIV and 783 (4.9%) with cancer	Female (18%); Male (82%)	Argentina, Brazil, and Mexico (UMICs), Chile (HIC), and Honduras (LMIC	Retrospective cohort	2000-2015	KS, NHL, & cervical	KS	Anal, breast, colon, HL, lung, prostate, renal, skin, testicular, & others	Anal	(i) 231/783 (30%) died; (ii) Survival in year 1 lower for ADCs & higher for NADC
Grover et al., 2018 [55]	81865 PLHIV and 814 (0.9%) with cancer	Female (4%); Male (96%)	USA & Canada (HIC)	Retrospective cohort	2000-2009	Invasive cervical	Cervical	Lung, anal oropharynx, & HL	Lung	(i) died; (ii) Lung cancer was leading mortality with 339 deaths
Ignacio et al., 2018 [11]	1137 with cancer, 257 (22.6%) PLHIV, and 548 (48.2%) HIV negative	Female (55.5%); Male (45.5%)	Uganda (LIC)	Cross-sectional	2015	Cervical, KS, and NHL	Cervical	Breast, esophageal, head & neck, colorectal, & prostate	Breast	No
Kowalkowski et al., 2014 [56]	31576 PLHIV, 967 (3.1%) with cancer (virus-related NADCs only)	Males only.	USA (HIC)	Retrospective cohort	1985-2010	No	N/A	Hepatocellular, anus, and HL	Hepatocellular	No
Nagata et al., 2018 [57]	1001 PLHIV and 61 (6.1%) with cancer (NADCs only)	Gender not specified	Japan (HIC)	Retrospective cohort	1997-2015	No	N/A	Liver, colorectal, colon, anorectal, gastric, lung, HL, & others	Liver	No
Park et al., 2018 [58]	4169 (9.8%) cancers in 42441 PLHIV and 7879 (7.5%) cancers in 104712 HIV negative	Gender not specified	USA (HIC)	Prospective cohort	1999-2015	NHL & KS	NHL	Anal, liver, lung, prostate, HL, HPV-related cancers, & others	Liver & prostate	No
Chiu et al., 2017 [31]	4918 PLHIV, 145 (2.9%) NADMs, & 123 (2.5%) ADMs	Female (11%); Male (89%)	Canada (HIC)	Retrospective cohort	1996-2008	Not specified	N/A	Lung, anal, breast, head/neck, prostate, liver, rectal, and renal	Lung	No
Engels et al., 2017 [59]	46956 PLHIV and 1997 (4.3%) with cancer	Gender not specified	USA & Canada (HIC)	Retrospective cohort	1995-2009	Cervical, KS, and NHL	NHL	Lung, anal, liver, & anal	Lung	(i) Deaths attributable to NADCs (7.1%) versus ADCs (2.6%); (ii) Over 50% of these deaths were attributable to NHL, lung, and liver cancers; (iii) Mortality /100000 PY of PWHIV higher than US general population during 2014 (186/100 000 PY)
Campbell et al., 2016 [60]	1127 PLHIV & also with cancer (NADCs only)	Female (36.4%); Male (63.6%),	Tanzania (LMIC)	Retrospective cohort	2002-2014	No	N/A	Lung, liver, and head & neck	Head & neck	No
Mayor et al., 2016 [61]	4213 PLHIV and 281 (6.7%) with cancer	Female (28%); Male (72%)	Puerto Rico (HIC)	Retrospective cohort	1992-2010	KS, NHL, & cervical	KS	Oro/pharynx, lung, bronchus, liver, anus colon/rectum, vagina, & others	Oropharynx	(i) Around 50% died within the first year of cancer diagnoses; (ii) Lung cancer was leading in 1-year mortality
Salters et al., 2016 [62]	2211 PLHIV and 77 (3.5%) with cancer	Females only ()	Canada (HIC)	Retrospective cohort	1994-2008	Cervical, NHL, and KS	Cervical	Breast, respiratory system, HL, & digestive system	Respiratory system	No
Yang et al., 2016 [63]	1946 PLHIV and 149 (7.7%) with cancer	Female (26.8%); Male (73.2%)	China (UMIC)	Retrospective cohort	2008-2013	NHL, KS, and cervical	NHL	Gastrointestinal, liver, HL, lung, & breast	HL	(i) Out of 149, 42 (28.2%) died, mortality /100 PY; (ii) More males () versus females died; (iii) Mortality rate for ADCs was higher (0.86) than NADCs (0.73)
Jaquet et al., 2015 [64]	1644 with cancer, 184 (11.2%) PLHIV, and 1460 (88.8%) HIV negative	Female (60.3%); Male (39.7%)	Benin, Côte d’Ivoire, and Nigeria (LMICs) and Togo (LIC)	Cross-sectional	2009-2012	Cervical, KS, and NHL	Cervical	Breast, liver, prostate, leukemia, colorectal, oropharynx, anogenital, & others	Breast	No
Raffetti et al., 2015 [65]	16268 PLHIV and 1159 (7.1%) with cancer	Female (21.6%); Male (78.4%)	Italy (HIC)	Retrospective cohort	1986-2012	KS, NHL, & cervical	KS	Liver, HL, colon, lung, rectum/anal, testes, larynx, penis, & others	Liver	(i) Annual standard mortality ratio (ASMR) for ADCs before and after 1998 decreased 2-3-fold from 96.1 to 29.1; (ii) ASMR for NADCs increased 2-fold from 14.3 to 27.5 around same period
Silverberg et al., 2015 [66]	86620 PLHIV and 196987 HIV negative	Gender not specified	USA & Canada (HIC)	Prospective cohort	1996-2009	KS and NHL	KS	Lung, anal, liver, HL colorectal, melanoma, oropharynx, & others	Lung	No
Gotti et al., 2014 [32]	13388 PLHIV and 866 (6.5%) with cancer	Female (22%); Male (78%)	Italy (HIC)	Retrospective cohort	1998-2012	KS, NHL, & cervical	NHL	Liver, HL, lung, & breast	Liver	No
Calabresi et al., 2013 [67]	5090 HIV-infected and 390 (7.7%) with cancer	Female (19.2%); Male (80.8%)	Italy (HIC)	Retrospective cohort	1999-2009	KS, NHL, & cervical	KS	HL, liver, melanoma, skin nonmelanin, trachea/lung, prostate, testes, & others	Virus related: liver; Nonvirus related: skin nonmelanin	No
Coghill et al., 2013 [68]	802 with cancer, 274 (34.2%) PLHIV, & 528 (65.8%) HIV negative	Gender not specified	Uganda (LIC)	Retrospective cohort	2003-2010	Cervical and NHL	Cervical	HL, breast, & esophageal	Breast in the HIV-infected and HL in the HIV-uninfected	(i) HIV-infected were more than twice as likely to die during the year following cancer diagnosis compared with HIV-uninfected cancer patients; (ii) HIV-infected diagnosed with infection-related cancers had greater than 50% higher risk of death during the year following cancer diagnosis; (iii) HIV-infected diagnosed with cancers without an infectious cause also experienced significantly higher risk of death
Yanik et al., 2013 [69]	11485 PLHIV and 457 (4%) with cancer	Gender not specified	USA (HIC)	Observational cohort	1996-2011	KS, NHL, & cervical	KS	Lung, anal, breast, liver prostate, HL, colorectal, melanoma, & others	Breast	No
Pinto et al., 2012 [70]	730 PLHIV and 30 (4.1%) with cancer	Female (33.3%); Male (66.7%)	Brazil (UMIC)	Cross-sectional	2010-2011	KS, cervical, & NHL	KS	Hepatocellular, prostate, lung, HL, laryngeal, renal, colon, & penis	Prostate	No
Achenbach et al., 2011 [71]	20,677 PLHIV and 650 (3.1%) with cancer	Female (14%); Male (86%)	USA) (HIC)	Multisite retro and prospective cohort	1996-2009	KS, cervical, & NHL	KS	Lung, anal, prostate, HL, breast, colorectal, liver, & others	Lung	(i) Crude mortality rate was 20.6/100 PY; (ii) Highest mortality was seen in primary CNS NHL, liver, and lung cancers
Dauby et al., 2011 [72]	3126 PLHIV and 45 (0.03%) with cancer (NADCs only)	Female (33.3%); Male (66.7%)	Belgium (HIC)	Retrospective cohort	2002-2009	No	N/A	HL, anal, lung, hepatocellular, prostate, bladder, breast, head & neck, & others	Anal in men; HL in women	Out of 45 diagnosed with cancer, 20 (44.4%) died

ADCs: AIDS-defining cancers; NADCs: non-AIDS-defining cancers; KS: Kaposi sarcoma; NHL: non-Hodgkin lymphoma; HL: Hodgkin lymphoma; SCCA: squamous cell carcinoma anus; HPV: human papillomavirus; ART: antiretroviral therapy; HAART: highly active antiretroviral therapy; PLHIV: people living with HIV; ASMR: adjusted standardized mortality rate; PY: person years; HIC: high-income country; UMIC: upper-middle income country; LMIC: lower-middle income country; LIC: low-income country.