Background
Methods
MASTER cohort and study population
Cancer diagnoses and deaths
Statistical analysis
Ethics procedures
Results
Cancer incidence
Variables | Categories | Total | ADC | NADC | Without cancer | P value |
---|---|---|---|---|---|---|
Total
| 16268 | 688 | 471 | 15109 | ||
Gender
|
Male
| 12116 (74.5) | 549 (79.8) | 360 (76.4) | 11207 (74.2) |
0.003
|
Female
| 4152 (25.5) | 139 (20.2) | 111 (23.6) | 3902 (25.8) | ||
Age at enrolment (years)
|
18-34
| 9797 (60.2) | 369 (53.6) | 228 (48.4) | 9200 (20.9) |
<0.001
|
35-44
| 4278 (26.3) | 189 (27.5) | 121 (25.7) | 3968 (26.3) | ||
45-54
| 1538 (9.5) | 91 (13.2) | 71 (15.1) | 1376 (9.1) | ||
55-64
| 513 (3.1) | 36 (5.2) | 41 (8.7) | 436 (2.9) | ||
>65
| 142 (0.9) | 3 (0.4) | 10 (2.1) | 129 (1.0) | ||
Mean (SD)
| 34.2 (9.8) | 35.6 (10.3) | 37.8 (11.9) | 34.1 (9.7) |
<0.001
| |
Year of enrolment
|
1986-1989
| 2275 (14.0) | 79 (16.8) | 135 (19.6) | 2061 (13.6) |
<0.001
|
1990-1993
| 2835 (17.4) | 99 (21.0) | 121 (17.6) | 2615 (17.3) | ||
1994-1997
| 2465 (15.1) | 98 (20.8) | 137 (19.9) | 2230 (14.8) | ||
1998-2001
| 2522 (15.5) | 73 (15.5) | 101 (14.7) | 2348 (15.5) | ||
2002-2005
| 2539 (15.6) | 70 (14.9) | 108 (15.7) | 2361 (15.6) | ||
2006-2012
| 3632 (22.3) | 52 (11.0) | 86 (12.5) | 3494 (23.1) | ||
IDUs
|
No
| 8374 (51.5) | 363 (52.8) | 200 (42.5) | 7811 (51.7) |
<0.001
|
Yes
| 7894 (48.5) | 325 (47.2) | 271 (57.5) | 7298 (48.3) | ||
HBV/HCV co-infection
|
No
| 8374 (51.5) | 363 (52.8) | 200 (42.5) | 7811 (51.7) |
<0.001
|
Yes
| 7894 (48.5) | 325 (47.2) | 271 (57.5) | 7298 (48.3) | ||
CD4 cell count , cell/mm3
|
0-49
| 1151 (7.1) | 95 (13.8) | 28 (5.9) | 1028 (6.8) |
<0.001
|
50-99
| 940 (5.8) | 59 (8.6) | 31 (6.6) | 850 (5.6) | ||
100-199
| 2038 (12.5) | 136 (19.8) | 70 (14.9) | 1832 (12.1) | ||
200-349
| 3464 (21.3) | 144 (20.9) | 100 (21.2) | 3220 (21.3) | ||
350-499
| 3346 (20.6) | 110 (16.0) | 107 (22.7) | 3129 (20.7) | ||
≥500
| 5329 (32.8) | 144 (20.9) | 135 (28.7) | 5050 (33.4) | ||
Mean (SD)
| 416.8 (298.6) | 316.7 (272.6) | 401.8 (300.8) | 421.8 (298.9) |
<0.001
| |
Log10 HIVRNA, copies/mL
|
Mean (SD)
| 3.1 (1.4) | 3.3 (1.5) | 3.0 (1.4) | 3.1 (1.4) | NS |
Treatment-naïve
|
No
| 14179 (87.2) | 610 (88.7) | 412 (87.5) | 13157 (87.1) | NS |
Yes
| 2089 (12.8) | 78 (11.3) | 59 (12.5) | 1952 (12.9) |
Observational-time | 1986-2009 | ||
---|---|---|---|
Cancer type or site (ICD-10) | Observed (n) | Expected (n) | SIR (95% CI) |
AIDS-defining-cancer
| |||
Kaposi’s sarcoma (C46) |
287
|
1.7
|
168.5 (149.6-189.2)
|
Cervix Uteri (C53)^ |
41
|
2.3
|
17.9 (12.8-24.2)
|
Non-Hodgkin lymphoma (C82-5, C96) |
313
|
12.8
|
24.5 (21.8-27.3)
|
Non-AIDS-defining-cancer
| |||
Tongue and lingual tonsil (C01-C02) |
5
|
0.2
|
22.1 (7.1-51.5)
|
Stomach (C16) | 9 | 6.5 | 1.4 (0.6-2.6) |
Colon (C18) |
32
|
14.2
|
2.2 (1.5-3.2)
|
Rectum-Anus (C19-21)
|
24
|
7.7
|
3.1 (2.0-4.7)
|
Liver, primary (C22) |
61
|
5.8
|
10.6 (8.1-13.6)
|
Larynx (C32) |
9
|
3.3
|
2.8 (1.3-5.3)
|
Lung, bronchus and trachea (C33-34) |
29
|
19.5
|
1.5 (1.0-2.1)
|
Melanoma (C43) | 14 | 12.9 | 1.1 (0.6-1.8) |
Breast (C50) | 32 | 24.7 | 1.3 (0.9-1.8) |
Vagina and vulva (C51-52, 57) |
5
|
0.2
|
22.1 (7.1-51.5)
|
Penis (C60) |
8
|
0.3
|
28.0 (12.1-55.2)
|
Prostate (C61) | 8 | 16.2 | 0.5 (0.3-1.0) |
Testis (C62) |
19
|
7.9
|
2.4 (1.4-3.7)
|
Kidney (C64-66, C68) | 9 | 8.9 | 1.0 (0.5-1.9) |
Bladder (C67) | 6 | 13.4 | 0.4 (0.2-1.0) |
Brain and CNS (C70-72) | 4 | 6 | 0.7 (0.2-1.7) |
Thyroid (C73) | 7 | 11.3 | 0.6 (0.2-1.3) |
Hodgkin lymphoma (C81) |
59
|
5
|
11.8 (9.0-15.2)
|
Myeloid leukaemia (C92) | 4 | 2.7 | 1.5 (0.4-3.7) |
Mortality
Age-standardized mortality rate (95% CI) | ||
---|---|---|
Before 1998 | After 1998 | |
ADC
| 96.1 (57.5-113.5) | 29.1 (23.0-35.3) |
NADC
| 14.3 (0.0-35.3) | 27.5 (22.5-32.6) |
Without cancer
| 56.7 (45.4-68.0) | 11.5 (10.5-12.6) |
Predictors of mortality for all causes
Univariate model | Multivariate model | ||||
---|---|---|---|---|---|
Variables | Categories | RR | 95% CI | RR* | 95% CI |
Gender
|
Male vs Female
| 1.55 | (1.42-1.70) | 1.24 | (1.12-1.36) |
Age at enrolment (years)
|
18-34
| Ref. | Ref. | ||
35-44
| 0.96 | (0.88-1.06) | 1.53 | (1.36-1.71) | |
45-54
| 1.28 | (1.12-1.47) | 2.41 | (2.05-2.83) | |
55-64
| 1.56 | (1.27-1.92) | 2.66 | (2.13-3.33) | |
≥65
| 3.06 | (2.24-4.19) | 5.41 | (3.89-7.52) | |
Year of enrolment
|
1986-1989
| 2.41 | (1.99-2.91) | 1.55 | (1.25-1.94) |
1990-1993
| 2.23 | (1.84-2.70) | 1.43 | (1.15-1.78) | |
1994-1997
| 1.63 | (1.34-1.98) | 0.89 | (0.71-1.10) | |
1998-2001
| 1.23 | (1.00-1.51) | 1.11 | (0.90-1.36) | |
2002-2005
| 1.01 | (0.81-1.27) | 1.00 | (0.80-1.26) | |
2006-2012
| Ref. | Ref. | |||
IDUs
|
Yes vs No
| 1.76 | (1.62-1.90) | 1.54 | (1.40-1.70) |
AIDS-event
|
Yes vs No
| 17.55 | (16.22-18.99) | 3.75 | (3.43-4.11) |
HBV/HCV co-infection
|
Yes vs No
| 0.95 | (0.89-1.03) | ||
CD4 cell count, cell/mm3
|
0-49
| 44.92 | (37.90-53.25) | 4.10 | (3.62-4.65) |
50-99
| 17.58 | (14.48-21.33) | 2.73 | (2.36-3.16) | |
100-199
| 7.78 | (6.45-9.39) | 1.83 | (1.62-2.08) | |
200-349
| 3.02 | (2.45-3.67) | 1.47 | (1.31-1.65) | |
350-499
| 1.64 | (1.32-2.04) | 1.15 | (1.01-1.30) | |
≥500
| Ref. | Ref. | |||
Antiretroviral therapy
|
cART
| Ref. | Ref. | ||
Subobtimal cART
| 3.26 | (2.91-3.65) | 2.18 | (1.95-2.44) | |
No therapy
| 2.14 | (1.96-2.33) | 8.19 | (7.23-9.27) | |
Cancer occurrence
|
Without cancer
| Ref. | Ref. | ||
ADC
| 14.60 | (12.51-17.03) | 1.22 | (1.08-1.38) | |
NADC
| 10.48 | (8.49-12.93) | 1.29 | (1.12-1.50) |