Abstract
BACKGROUND: Risk of cancer is increased in HIV-infection. To our knowledge, no previous study has examined the association between socioeconomic position and risk and prognosis of cancer among HIV-infected individuals.
METHODS: Population-based cohort-study including HIV-infected individuals diagnosed in Denmark 1995-2011 (without intravenous drug abuse or hepatitis C infection) (n=3,205), and a comparison cohort from the background population individually-matched by age, gender and country of birth (n=22,435). Educational level (low or high) and cancer events were identified in Danish national registers. Cumulative incidences, Incidence rate ratio (IRR) and survival using Kaplan-Meier methods were estimated.
RESULTS: Low educational level was associated with increased risk of cancer among HIV-infected individuals compared to the comparison cohort: all cancers (Adjusted-IRRs: 1.4(95% CI;1.1-1.7) vs. 1.1(95% CI;0.9-1.2)), tobacco- & alcohol-related cancers (2.1(95% CI;1.3-3.4) vs. 1.3(95% CI;1.1-1.6)), and other cancers (1.7(95% CI;1.1-2.8) vs. 0.9(95% CI;0.7-1.0)). No association with educational level was found for Infection-related or Ill-defined cancers. 1-year-survival was not associated with educational level, but 5-year-survival following Infection-related and Ill-defined cancers was lower among HIV-infected individuals with low educational level.
CONCLUSION: Education is associated with risk and prognosis of some cancers in HIV-infection, and this association diverges from what is observed in the background population.
Original language | English |
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Journal | Journal of Infectious Diseases |
Volume | 212 |
Issue number | 10 |
Pages (from-to) | 1552-1562 |
Number of pages | 11 |
ISSN | 0022-1899 |
DOIs | |
Publication status | Published - 2015 |