INCIDENCE OF HUMAN IMMUNODEFICIENCY VIRUS-RELATED AND NONRELATED MALIGNANCIES IN A LARGE COHORT OF HOMOSEXUAL MEN

Purpose: To determine if the rates of malignancies other than Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL) are increased in human immunodeficiency virus (HIV)-infected homosexual men. Subjects and Met hods: From 1984 through 1993, 1,199 homosexual men were studied in the Pittsburgh component of the Multicenter AIDS Cohort Study (MACS), an examination of the natural history of HIV infection. The cohort consis ted of 769 HIV-seronegative (SN) participants and 430 seropositive (SP ) members who were either seroprevalent at the time of enrollment or w ho seroconverted during the study. Cancer incidence data were collecte d through semiannual visits, phone interviews, medical records, and de ath certificates. Five thousand seven hundred eight person-years and 2 ,344 person-years were contributed to the study by the SN and SP men, respectively. Results: In addition to 44 cases of K5, 13 NHLs, and 3 C NS lymphomas (CNSLs), 27 other malignancies occurred (three nonmelanom a skin cancers and eight other malignancies in the SP group, eight non melanoma skin cancers, and eight other malignancies in the SN group). Age-adjusted rates were calculated for both groups and compared with e ach other and with rates for the general male population in Pennsylvan ia. There were no differences between the SN group and the general pop ulation. Among the SP group, the combined frequency of all cancers oth er than KS, NHL, CNSL, and nonmelanoma skin cancers was statistically significantly increased in comparison to both the SN group and the gen eral population. This increase was secondary to an unusually increased frequency of both seminoma and Hodgkin's disease. Conclusion: These f indings support the hypothesis that the incidences of cancers other th an KS and lymphoma are moderately increased in the setting of HIV infe ction and immunosuppression. (C) 1995 by American Society of Clinical Oncology.