| Underestimation of relative risks by standardized incidence ratios for AIDS-related cancers. | |
| | |
MedLine Citation:
|
PMID: 18083545 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
PURPOSE: Registry-based studies provide valuable data regarding cancer risk among people with HIV/AIDS (PWHA). Such studies utilize the standardized incidence ratio (SIR) to estimate the relative risk (RR), an etiologically relevant measure. However, SIR may underestimate RR when HIV/AIDS prevalence in the general population or RR is high. We quantified the extent of this underestimation for 3 AIDS-related cancers: Kaposi sarcoma (KS), central nervous system non-Hodgkin lymphoma (CNS NHL) and cervical cancer. METHODS: We used data on cancer risk among PWHA from the U.S. HIV/AIDS Cancer Match Study. SIRs were compared with RRs estimated using two methods: (1) SIRs calculated using pre-AIDS era (1973-1979) cancer incidence rates (SIRpre-AIDS) and (2) SIRs calculated after subtraction of cancers known to be among PWHA from general population rates (SIRexclusion). RESULTS: For KS and CNS NHL, SIRs (117.8 and 133.9, respectively) calculated using overall general population rates substantially underestimated both SIRpre-AIDS (19,778 and 3,612, respectively) and SIRexclusion (657.7 and 536.4, respectively). In contrast, the extent of underestimation was negligible for cervical cancer (SIR = 4.9 vs. SIRexclusion = 5.1). For KS and CNS NHL, SIRs were higher in females than in males. However, SIRpre-AIDS and SIRexclusion estimates were more similar, indicating that SIR differences artifactually reflect differences in HIV/AIDS prevalence between males and females. For KS and CNS NHL, trends across calendar time were weaker in SIRs than in SIRpre-AIDS and SIRexclusion. CONCLUSION: For KS and CNS NHL, SIRs substantially underestimate RRs. This underestimation arises from the exceptionally high relative risk of KS and CNS NHL among PWHA. SIRs must be interpreted cautiously when HIV/AIDS prevalence is high or varies across groups of interest. |
| | |
Authors:
|
Anil K Chaturvedi; Sam M Mbulaiteye; Eric A Engels |
Related Documents
:
|
2022595 - Treatment of aids-related kaposi's sarcoma. 3659175 - Primary kaposi's sarcoma of an intraparotid lymph node with aids. 7554505 - Kaposi's sarcoma. how can epidemiology help find the cause? 9250545 - Kaposi's sarcoma: advances in tumor biology and pharmacotherapy. 1299705 - Generations and paradigms: mainstreams in lesbian and gay studies. 15736665 - Reducing unwanted pregnancies in greenland. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Annals of epidemiology Volume: 18 ISSN: 1047-2797 ISO Abbreviation: Ann Epidemiol Publication Date: 2008 Mar |
Date Detail:
|
Created Date: 2008-02-18 Completed Date: 2008-06-03 Revised Date: 2008-06-23 |
Medline Journal Info:
|
Nlm Unique ID: 9100013 Medline TA: Ann Epidemiol Country: United States |
Other Details:
|
Languages: eng Pagination: 230-4 Citation Subset: IM |
Affiliation:
|
Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, EPS 7072, Rockville, MD 20852, USA. chaturva@mail.nih.gov <chaturva@mail.nih.gov> |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Central Nervous System Neoplasms
/
epidemiology* Female HIV Infections / complications* Humans Incidence Lymphoma, AIDS-Related / epidemiology* Lymphoma, Non-Hodgkin / epidemiology* Male Medical Record Linkage Poisson Distribution Prevalence Registries Risk Sarcoma, Kaposi / epidemiology* United States / epidemiology Uterine Cervical Neoplasms / epidemiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Trajectory and socioeconomic predictors of depression in a prospective study of residents of New Yor...
Next Document: Obesity and adult asthma: potential effect modification by gender, but not by hay fever.