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Cancer Incidence and Cancer Screening Practices Among a Cohort of Persons Receiving HIV Care in Washington, DC

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Abstract

In this era of effective combination antiretroviral therapy the incidence of AIDS defining cancers (ADCs) is projected to decline while the incidence of certain non-AIDS defining cancers (NADCs) increases. Some of these NADCs are potentially preventable with appropriate cancer screening. We examined cancer incidence, screening eligibility, and receipt of screening among persons actively enrolled in the DC Cohort, a longitudinal observational cohort of PLWH, between 2011 and 2017. Cancer screening eligibility was determined based on age, sex, smoking history and co-morbidity data available and published national guidelines. The incidence rate of NADCs was 12.1 (95% CI 10.7, 13.8) and ADCs 1.6 (95% CI 0.6, 4.6) per 1000 person-years. The most common incident NADCs were breast 2.6 (95% CI 0.5,1 2.1), prostate 2.3 (95% CI 1.2, 4.3), and non-melanoma skin 1.2 (95% CI 0.6, 2.3) incident diagnoses/cases per 1000 person-years. Among cohort sites where receipt of cancer screening was assessed, less than 60% of eligible participants had any ascertained anal HPV, breast, cervical, colorectal, hepatocellular carcinoma, or lung cancer screening. In this cohort of PLWH, there were more incident NADCs versus ADCs in contrast to earlier cohort studies where ADCs predominated. Despite a large eligible population there were low rates of screening. Implementation of cancer screening is an important component of care among PLWH.

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Acknowledgements

This work was supported by the National Institute of Allergy and Infectious Diseases at the National Institutes of Health under Grant UM1 AI69503. Data was collected by the DC Cohort investigators and research staff at: Cerner Corporation (Jeffrey Binkley, Cheryl Akridge, Thilia Subramanian, Qingjiang Hou, Stacey Purinton, Nabil Rayeed, Rob Taylor); Children’s National Medical Center Adolescent (Lawrence D’Angelo) and Pediatric (Natella Rakhmanina) clinics; The Senior Deputy Director of the DC Department of Health HAHSTA (Michael Kharfen); Family and Medical Counseling Service (Michael Serlin); Georgetown University (Princy Kumar); George Washington Medical Faculty Associates(David Parenti); George Washington University Department of Epidemiology and Biostatistics (Anne Monroe, James Peterson, Lindsey Powers Happ, Maria Jaurretche, Brittany Wilbourn, and Kevin Trac); Howard University (Ronald Wilcox); La Clínica Del Pueblo (Ricardo Fernandez); MetroHealth (Annick Hebou); National Institutes of Health (Carl Dieffenbach);Unity Health Care (Gebeyehu Teferi); Veterans Affairs Medical Center (Debra Benator); Washington Hospital Center (Maria Elena Ruiz); Whitman‐Walker Health (David Hardy, Deborah Goldstein); Kaiser Permanente (Michael Horberg). We would also like to acknowledge the Research Assistants at all of the participating sites, the DC Cohort Community Advisory Board and the DC Cohort participants. This research has been facilitated by the services and resources provided by the District of Columbia Center for AIDS Research, an NIH funded program (AI117970), which is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, NIDDK, NIMHD, NIDCR, NINR, FIC and OAR. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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  1. Georgetown University Medical Center, 3800 Reservoir Road NW, 5th Floor PHC, Washington, DC, 20008, USA

    Amanda Blair Spence, Joseph Timpone & Princy Kumar

  2. George Washington University Milken Institute School of Public Health, Washington, DC, USA

    Matthew E. Levy, Anne Monroe & Amanda Castel

  3. Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD, USA

    Michael Horberg

  4. Georgetown University Lombardi Comprehensive Cancer Center, Washington, DC, USA

    Lucile Adams-Campbell

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Spence, A.B., Levy, M.E., Monroe, A. et al. Cancer Incidence and Cancer Screening Practices Among a Cohort of Persons Receiving HIV Care in Washington, DC. J Community Health 46, 75–85 (2021). https://doi.org/10.1007/s10900-020-00844-6

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