Skip to main content

Advertisement

Log in

Changing incidence of AIDS-related Kaposi sarcoma and non-Hodgkin lymphoma in Ontario, Canada

  • Original Paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Objective

To examine the influence of the AIDS epidemic on the incidence of Kaposi sarcoma (KS) and non-Hodgkin lymphoma (NHL) in Ontario.

Methods

Age-standardized incidence rates for KS and NHL from 1981 to 2000 were calculated from the population-based Ontario Cancer Registry. AIDS cases were extracted from Ontario Ministry of Health and Long-Term Care reports. HIV death data were obtained from the Ontario Cancer Registry.

Results

KS was a rare cancer before the 1980s; however, incidence increased sharply between 1985 and 1995 by 13.8% per year. Thereafter, incidence rates fell close to those in the early 1980s. NHL incidence in males increased steadily during the 1980s at 3.2% per year and then slowed beyond 1990. In males aged 30–44, NHL incidence rose from 1981 to 1990 (8.8% per year) and then fell (−2.5%) thereafter. NHL and KS cases represented one-third of HIV deaths.

Conclusions

The AIDS epidemic, the introduction of antiretroviral therapies, and the decrease in HIV infection rates explain the rise and decline of KS incidence in Ontario. NHL incidence trends are more complex, although the AIDS epidemic explains the trends observed in younger men (in whom AIDS is more common), and for the AIDS-related subtypes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Eltom MA, Jemal A, Mbulaiteye SM, Devesa SS (2002) Trends in Kaposi’s sarcoma and non-Hodgkin’s lymphoma incidence in the United States from 1973 through 1998. J Natl Cancer Inst 94:1204–1210

    PubMed  Google Scholar 

  2. Biggar RJ (2001) AIDS-related cancers in the era of highly active antiretroviral therapy. Oncology (Williston Park) 15:439–449

    CAS  Google Scholar 

  3. Hymes KB, Cheung T, Greene JB et al (1981) Kaposi’s sarcoma in homosexual men-a report of eight cases. Lancet 2:598–600. doi:10.1016/S0140-6736(81)92740-9

    Article  PubMed  CAS  Google Scholar 

  4. Friedman-Kien AE (1981) Disseminated Kaposi’s sarcoma syndrome in young homosexual men. J Am Acad Dermatol 5:468–471

    Article  PubMed  CAS  Google Scholar 

  5. Ziegler JL, Drew WL, Miner RC et al (1982) Outbreak of Burkitt’s-like lymphoma in homosexual men. Lancet 2:631–633. doi:10.1016/S0140-6736(82)92740-4

    Article  PubMed  CAS  Google Scholar 

  6. Ziegler JL, Beckstead JA, Volberding PA et al (1984) Non-Hodgkin’s lymphoma in 90 homosexual men. Relation to generalized lymphadenopathy and the acquired immunodeficiency syndrome. N Engl J Med 311:565–570

    PubMed  CAS  Google Scholar 

  7. Centre for Disease Control (1992) 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Morb Mortal Wkly Rep 41(17):1–20

    Google Scholar 

  8. Gail MH, Pluda JM, Rabkin CS et al (1991) Projections of the incidence of non-Hodgkin’s lymphoma related to acquired immunodeficiency syndrome. J Natl Cancer Inst 83:695–701. doi:10.1093/jnci/83.10.695

    Article  PubMed  CAS  Google Scholar 

  9. Montaner JSG, Le T, Hogg R et al (1994) The changing spectrum of AIDS index diseases in Canada (short communication). AIDS 8:693–696. doi:10.1097/00002030-199405000-00018

    Article  PubMed  CAS  Google Scholar 

  10. Public Health Agency of Canada (2006) HIV and AIDS in Canada. Surveillance Report to June 30, 2006. Surveillance and Risk Assessment Division, Centre for Infectious Disease Prevention and Control, Public Health Agency of Canada, p 35

  11. Public Health Agency of Canada (2006) Cancer Surveillance On-Line. Cancer incidence over time (Kaposi sarcoma, males, all ages, Ontario, 1992–2004). http://dsol-smed.phac-aspc.gc.ca/dsol-smed/cancer/c_time_e.html. Accessed 23 May 2008

  12. Clarke CA, Glaser SL, Dorfman RF, Bracci PM, Eberle E, Holly EA (2004) Expert review of non-Hodgkin’s lymphoma in a population-based cancer registry: reliability of diagnosis and subtype classifications. Cancer Epidemiol Biomarkers Prev 13:138–143. doi:10.1158/1055-9965.EPI-03-0250

    Article  PubMed  Google Scholar 

  13. Clarke CA, Undurraga DM, Harasty PJ, Glaser SL, Morton LM, Holly EA (2006) Changes in cancer registry coding for lymphoma subtypes: reliability over time and relevance for surveillance and study. Cancer Epidemiol Biomarkers Prev 15:630–638. doi:10.1158/1055-9965.EPI-05-0549

    Article  PubMed  Google Scholar 

  14. Morton LM, Turner JJ, Cerhan JR et al (2007) Proposed classification of lymphoid neoplasms for epidemiologic research from the Pathology Working Group of the International Lymphoma Epidemiology Consortium (InterLymph). Blood 110:695–708. doi:10.1182/blood-2006-11-051672

    Article  PubMed  CAS  Google Scholar 

  15. Holowaty E (1998) The Ontario Cancer Registry. In: Black RJ, Simonato L, Storm HH, Demaret E (eds) Automated data collection in cancer registration. International Agency for Research on Cancer (IARC), Lyon, pp 2–34 (IARC Technical Report No. 32)

    Google Scholar 

  16. Percy C, Van Holten V, Muir C (eds) (1990) international classification of disease for oncology, 2nd edn. World Health Organization, Geneva, Switzerland, pp xxxiv, 45–47

  17. Percy C, O’Conor G, Ries LG, Jaffe ES (1984) Non-Hodgkin’s lymphomas. Application of the International Classification of Diseases for Oncology (ICD-O) to the Working Formulation. Cancer 54:1435–1438. doi:10.1002/1097-0142(19841001)54:7<1435::AID-CNCR2820540734>3.0.CO;2-O

    Article  PubMed  CAS  Google Scholar 

  18. The Non-Hodgkin’s Lymphoma Pathologic Classification Project (1982) National Cancer Institute sponsored study of classifications of non-Hodgkin’s lymphomas: summary and description of a working formulation for clinical usage. Cancer 49:2112–2135. doi:10.1002/1097-0142(19820515)49:10<2112::AID-CNCR2820491024>3.0.CO;2-2

    Article  Google Scholar 

  19. Carbone A (2003) Emerging pathways in the development of AIDS-related lymphomas. Lancet 4:22–29. doi:10.1016/S1470-2045(03)00957-4

    Article  CAS  Google Scholar 

  20. Remis RS, Swantee C, Rottensten K, Schiedel L, Merid MF (2003) Report on HIV/AIDS in Ontario 2002. Ontario Ministry of Health, Toronto, Canada

    Google Scholar 

  21. Health Canada (1987) Revision of the CDC surveillance case definition for Acquired Immunodeficiency Syndrome. Can Dis Wkly Rep 13:169–176

    Google Scholar 

  22. Health Canada (1993) Revision of the surveillance case definition for AIDS in Canada. Can Commun Dis Rep 19:116–117

    Google Scholar 

  23. SAS Institute Inc. (1999–2001) SAS/Stat Software: changes and enhancements through Release 8.02. SAS Institute Inc., Cary, NC

  24. National Cancer Institute (2003) Statistical research and applications branch. Joinpoint Regression Program, Version 2.7. USA

  25. Adib SM, Joseph JG, Ostrow DG, Tal M, Schwartz SA (1991) Relapse in sexual behavior among homosexual men: a 2-year follow-up from the Chicago MACS/CCS. AIDS 5:757–760. doi:10.1097/00002030-199106000-00018

    Article  PubMed  CAS  Google Scholar 

  26. Sandin S, Hjalgrim H, Glimelius B, Rostgaard K, Pukkala E, Askling J (2006) Incidence of non-Hodgkin’s lymphoma in Sweden, Denmark, and Finland from 1960 through 2003: an epidemic that was. Cancer Epidemiol Biomarkers Prev 15:1295–1300. doi:10.1158/1055-9965.EPI-05-0958

    Article  PubMed  Google Scholar 

  27. Rabkin CS, Biggar RJ, Horm JW (1991) Increasing incidence of cancers associated with the human immunodeficiency virus epidemic. Int J Cancer 47:692–696. doi:10.1002/ijc.2910470511

    Article  PubMed  CAS  Google Scholar 

  28. Roche LM, Paul SM, Costa SJ (2001) Acquired immune deficiency syndrome and the increase in non-Hodgkin lymphoma incidence in New Jersey from 1979 to 1996: An age specific analysis. Cancer 92:2948–2956. doi:10.1002/1097-0142(20011201)92:11<2948::AID-CNCR10127>3.0.CO;2-T

    Article  PubMed  CAS  Google Scholar 

  29. Clarke CA, Glaser SL (2002) Changing incidence of non-Hodgkin lymphomas in the United States. Cancer 94:2015–2023. doi:10.1002/cncr.10403

    Article  PubMed  Google Scholar 

  30. Cote TR, Biggar RJ, Rosenberg PS et al (1997) Non-Hodgkin’s lymphoma among people with AIDS: incidence, presentation and public health burden. AIDS/Cancer Study Group. Int J Cancer 73:645–650. doi:10.1002/(SICI)1097-0215(19971127)73:5<645::AID-IJC6>3.0.CO;2-X

    Article  PubMed  CAS  Google Scholar 

  31. Beral V, Peterman T, Berkelman R, Jaffe H (1991) AIDS-associated non-Hodgkin lymphoma. Lancet 337:805–809. doi:10.1016/0140-6736(91)92513-2

    Article  PubMed  CAS  Google Scholar 

  32. Biggar RJ, Engels EA, Frisch M, Goedert JJ, AIDS Cancer Match Registry Study Group (2001) Risk of T-cell lymphomas in persons with AIDS. J Acquir Immune Defic Syndr 26:371–376

    PubMed  CAS  Google Scholar 

  33. Goedert JJ, Cote TR, Virgo P et al (1998) Spectrum of AIDS-associated malignant disorders. Lancet 351:1833–1839. doi:10.1016/S0140-6736(97)09028-4

    Article  PubMed  CAS  Google Scholar 

  34. Holly EA, Lele C, Bracci P (1997) Non-Hodgkin’s lymphoma in homosexual men in the San Francisco Bay Area: occupational, chemical, and environmental exposures. J Acquir Immune Defic Syndr Hum Retrovirol 15:223–231

    PubMed  CAS  Google Scholar 

  35. Holly EA, Gautam M, Bracci PM (2002) Comparison of interviewed and non-interviewed non-Hodgkin’s lymphoma (NHL) patients in the San Francisco Bay Area. Ann Epidemiol 12:419–425. doi:10.1016/S1047-2797(01)00287-3

    Article  PubMed  Google Scholar 

  36. Grulich AE, Li Y, McDonald AM, Correll PK, Law MG, Kaldor JM (2001) Decreasing rates of Kaposi’s sarcoma and non-Hodgkin’s lymphoma in the era of potent combination anti-retroviral therapy. AIDS 15:629–633. doi:10.1097/00002030-200103300-00013

    Article  PubMed  CAS  Google Scholar 

  37. Brodt HR, Kamps BS, Gute P, Knupp B, Stasweweski S, Helm EB (1997) Changing incidence of AIDS-defining illnesses in the era of antiretroviral combination therapy. AIDS 11:1731–1738. doi:10.1097/00002030-199714000-00010

    Article  PubMed  CAS  Google Scholar 

  38. Buchbinder SP, Holmberg SD, Scheer S, Colfax G, O’Malley P, Vittinghoff E (1999) Combination antiretroviral therapy and incidence of AIDS-related malignancies. J Acquir Immune Defic Synd 21(Suppl 1):S23–S26

    CAS  Google Scholar 

  39. Dore G, Li Y, Grulich A et al (1996) Declining incidence and later occurrence of KS among persons with AIDS in Australia: the Australian AIDS cohort. AIDS 10:1401–1406

    Article  PubMed  CAS  Google Scholar 

  40. International Collaboration on HIV and Cancer (2000) Highly active antiretroviral therapy and incidence of cancer in human immunodeficiency virus-infected adults. J Natl Cancer Inst 92:1823–1830. doi:10.1093/jnci/92.22.1823

    Article  Google Scholar 

  41. Jones JL, Hanson DL, Dworkin MS, Jaffe HW, Adult/Adolescent Spectrum of Disease Project Group (2000) Incidence and trends in Kaposi’s sarcoma in the era of effective antiretroviral therapy. J Acquir Immune Defic Synd 24:270–274

    CAS  Google Scholar 

  42. Mocroft A, Kirk O, Clumeck N et al (2004) The changing pattern of Kaposi sarcoma in patients with HIV, 1994–2003: the EuroSIDA Study. Cancer 100:2644–2654. doi:10.1002/cncr.20309

    Article  PubMed  Google Scholar 

  43. Ledergerber B, Egger M, Ererd V, Swiss HIV Cohort Study et al (1999) AIDS-related opportunistic illnesses occurring after initiation of potent antiretroviral therapy: the Swiss HIV Cohort Study. JAMA 282:2220–2226. doi:10.1001/jama.282.23.2220

    Article  PubMed  CAS  Google Scholar 

  44. Jones JL, Hanson DL, Dworkin MS, Ward JW, Jaffe HW (1999) Effect of antiretroviral therapy on recent trends in selected cancers among HIV-infected persons Adult/Adolescent Spectrum of HIV Disease Project Group. J Acquir Immune Defic Synd 21(Suppl 1):S11–S17

    CAS  Google Scholar 

  45. Kinlen L (1992) Immunosuppressive therapy and acquired immunological disorders. Cancer Res 52(19 suppl):5474s–5476s

    PubMed  CAS  Google Scholar 

  46. Grulich AE (1999) AIDS-associated non-Hodgkin’s lymphoma in the era of highly active antiretroviral therapy. J Acquir Immune Defic Synd 21(Suppl 1):S27–30

    CAS  Google Scholar 

  47. Selik RM, Chu SY, Ward JW (1995) Trends in infectious diseases and cancers among persons dying of HIV infection in the United States from 1987 to 1992. Ann Intern Med 123:933–936

    PubMed  CAS  Google Scholar 

  48. Selik RM, Byers RH Jr, Dworkin MS (2002) Trends in diseases reported on US death certificates that mentioned HIV infection, 1987–1999. J Acquir Immune Defic Synd 29:378–387

    Google Scholar 

  49. Selik RM, Anderson RN, McKenna MT, Rosenberg HM (2003) Increase in deaths caused by HIV infection due to changes in rules for selecting underlying cause of death. J Acquir Immune Defic Synd 32:62–69

    Google Scholar 

  50. Selik RM, Rabkin CS (1998) Cancer death rates associated with human immunodeficiency virus infection in the United States. J Natl Cancer Inst 90:1300–1302. doi:10.1093/jnci/90.17.1300

    Article  PubMed  CAS  Google Scholar 

  51. Canadian AIDS Society and Health Canada (2002) A guide to HIV/AIDS epidemiological and surveillance terms. Canadian AIDS Society; Centre for Infectious Diseases Prevention and Control (CIDPC), Public Health Agency of Canada, Health Canada, Ottawa, Canada

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Saira Bahl.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bahl, S., Theis, B., Nishri, D. et al. Changing incidence of AIDS-related Kaposi sarcoma and non-Hodgkin lymphoma in Ontario, Canada. Cancer Causes Control 19, 1251–1258 (2008). https://doi.org/10.1007/s10552-008-9196-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-008-9196-8

Keywords

Navigation