Risk for Secondary Tumors After Kaposi Sarcoma Has Changed in the HAART Era
Risk for secondary cancer in patients with HIV who develop Kaposi sarcoma have changed. Photo Credit: ISM
New research published in JAMA Oncology reports that risk for secondary cancers after Kaposi sarcoma (KS) has declined, but certain newer cancers are on the rise, calling for closer monitoring and screening of patients with KS.
It has been known since the 1980s that people infected with HIV/AIDS who develop KS are at higher risk for secondary cancers. But because the demographics of who has HIV/AIDS and KS have changed, and because these patients are also living longer, researchers speculated that the risk for secondary cancers in these patients has also changed.
Researchers at the University of South Florida examined data from 9 cancer registries in the Surveillance, Epidemiology, and End Results (SEER) database for 14,905 patients diagnosed with KS from 1973 through 2013.
The researchers looked at incidence of secondary cancers 2 months after diagnosis with KS. They focused on rates for such cancers pre-AIDS (1973-1979), before the period of highly active antiretroviral therapy (HAART, 1980-1995), and during the HAART era (1996-2013).
Risk of developing any secondary cancer declined significantly during the period studied, from a standardized incidence ratio of 3.36 before HAART to a ratio of 1.94 during HAART. From 1980 to 1995, secondary cancers after KS were cancers of the rectum, anus, liver, and cervix, as well as Hodgkin lymphoma and non-Hodgkin lymphoma. From 1996 to 2013, the secondary cancers most associated with KS are cancers of the anus and liver and Hodgkin lymphoma and non-Hodgkin lymphoma. However, there was an increase in the risk for newer cancers in the HAART era compared with the pre-HAART era, such as acute lymphocytic leukemia, cancer of the tongue, and cancer of the penis.
These findings suggest a call for closer monitoring and screening of patients with KS for these newer cancers.
Mukhtar F, Ilozumba M, Utuama O, Cimenier O. Change in pattern of secondary cancers after Kaposi sarcoma in the era of antiretroviral therapy [published online August 24, 2017]. JAMA Oncology. doi: 10.1001/jamaoncol.2017.2395