Cervical and lung cancers are frequent and aggressive in women with HIV

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NEW YORK (Reuters Health) – Lung and cervical cancers, as well as typical AIDS-defining cancers, occur frequently in women with HIV infection, according to new findings published in the December 1st issue of the International Journal of Cancer.

"The early age of onset (average age 40 years old) and aggressiveness of the lung cancers (all died within 6 months of diagnosis)" in these patients "are worrisome," study director, Dr. Scott D. Holmberg, of the US Centers for Disease Control and Prevention, in Atlanta told Reuters Health.

Dr. Holmberg and a multicenter team examined the cancer rates in women with HIV infection, and in those at high risk of HIV infection, using data from the HIV Epidemiology Research Study. Overall, 1310 women enrolled at four urban research centers from 1993 to 1995 were included in the study.

Women with HIV infection were diagnosed with a total of 26 cancers during the study, including "eight non-Hodgkin's lymphomas, five invasive cervical cancers, one Kaposi's sarcoma and 12 non-AIDS defining cancers, including four lung cancers," the investigators write. In comparison, only four cancers were diagnosed in uninfected women during the period, including one lung cancer (p = 0.01 for all cancers and p < 0.0000001 for lung cancers).

In the cohort as a whole, 85% of women reported a history of cigarette smoking, and half had a history of injection drug use.

The rate of cervical cancers in HIV-infected women supports their inclusion as AIDS defining cases, the researchers point out. They add that the nonsmall-cell-lung cancers in the HIV-infected group are particularly notable, since they all occurred at a young age and had adenocarcinoma histology, an aggressive course, and short survival.

"Clinicians need to be aware of the much increased occurrence of this [lung] cancer and perhaps other non-traditional AIDS cancers in their patients," Dr. Holmberg continued. "Our results certainly reinforce the importance of getting HIV-infected persons to cease cigarette smoking and, in women, to be monitored with regular Pap smears."

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