Cancer burden attributable to cigarette smoking among HIV-infected people in North America.

Autor:	Altekruse SF; Division of Cancer Control and Population Sciences., Shiels MS; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda., Modur SP; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Land SR; Division of Cancer Control and Population Sciences., Crothers KA; University of Washington School of Medicine, Seattle, Washington., Kitahata MM; University of Washington School of Medicine, Seattle, Washington., Thorne JE; Johns Hopkins Medical Institute, Baltimore, Maryland., Mathews WC; University of California at San Diego Health System, San Diego, California., Fernández-Santos DM; Universidad Central del Caribe School of Medicine, Bayamón, Puerto Rico, USA., Mayor AM; Universidad Central del Caribe School of Medicine, Bayamón, Puerto Rico, USA., Gill JM; Alberta Health Services, Calgary, Alberta, Canada., Horberg MA; Kaiser Permanente Division of Research, Rockville, Maryland., Brooks JT; Centers for Disease Control and Prevention, Atlanta, Georgia., Moore RD; Johns Hopkins Medical Institute, Baltimore, Maryland., Silverberg MJ; Kaiser Permanente Division of Research, Oakland, California, USA., Althoff KN; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Engels EA; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda.
Jazyk:	angličtina
Zdroj:	AIDS (London, England) [AIDS] 2018 Feb 20; Vol. 32 (4), pp. 513-521.
DOI:	10.1097/QAD.0000000000001721
Abstrakt:	Objective: With combination-antiretroviral therapy, HIV-infected individuals live longer with an elevated burden of cancer. Given the high prevalence of smoking among HIV-infected populations, we examined the risk of incident cancers attributable to ever smoking cigarettes. Design: Observational cohort of HIV-infected participants with 270 136 person-years of follow-up in the North American AIDS Cohort Collaboration on Research and Design consortium. Among 52 441 participants, 2306 were diagnosed with cancer during 2000-2015. Main Outcome Measures: Estimated hazard ratios and population-attributable fractions (PAF) associated with ever cigarette smoking for all cancers combined, smoking-related cancers, and cancers that were not attributed to smoking. Results: People with cancer were more frequently ever smokers (79%) compared with people without cancer (73%). Adjusting for demographic and clinical factors, cigarette smoking was associated with increased risk of cancer overall [hazard ratios = 1.33 (95% confidence interval: 1.18-1.49)]; smoking-related cancers [hazard ratios = 2.31 (1.80-2.98)]; lung cancer [hazard ratios = 17.80 (5.60-56.63)]; but not nonsmoking-related cancers [hazard ratios = 1.12 (0.98-1.28)]. Adjusted PAFs associated with ever cigarette smoking were as follows: all cancers combined, PAF = 19% (95% confidence interval: 13-25%); smoking-related cancers, PAF = 50% (39-59%); lung cancer, PAF = 94% (82-98%); and nonsmoking-related cancers, PAF = 9% (1-16%). Conclusion: Among HIV-infected persons, approximately one-fifth of all incident cancer, including half of smoking-related cancer, and 94% of lung cancer diagnoses could potentially be prevented by eliminating cigarette smoking. Cigarette smoking could contribute to some cancers that were classified as nonsmoking-related cancers in this report. Enhanced smoking cessation efforts targeted to HIV-infected individuals are needed.
Databáze:	MEDLINE
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