Spectrum of HIV/AIDS related cancers in India.

OBJECTIVE

To study the cancer pattern among HIV positive cancer cases.

METHOD: The study group included patients registered in the HIV Cancer clinic at the Tata Memorial Hospital (TMH), Mumbai, which is the largest tertiary referral cancer center in India. We used the gender and age-specific proportions of each cancer site of the year 2002 that was recorded in the Hospital Cancer Registry to estimate an expected number of various cancer sites among HIV positive cancer patients during the period 2001-2005. The observed number of site-specific cancer cases was divided by the expected number to obtain proportional incidence ratio (PIR).

RESULTS

No case of Kaposi's sarcoma was observed. Increased proportion of non-Hodgkin's lymphoma (NHL) was observed (PIR in males = 17.1, 95%CI 13.33-21.84, females = 10.3, 95%CI 6.10-17.41). In males, PIR was increased for anal cancer (PIR = 10.3, 95%CI 4.30-24.83), Hodgkin's disease, testicular cancer, colon cancer, and few head and neck cancer sites. Among females, the PIRs for cervical cancer (PIR = 4.1, 95%CI 2.90-5.75), vaginal cancer (PIR = 7.7, 95%CI 2.48-23.85), and anal cancer (PIR = 6.5, 95%CI 0.91-45.88) were increased.

CONCLUSIONS

The absence of Kaposi's sarcoma and increased PIRs for certain non-AIDS defining cancers among HIV infected cancer cases indicates a different spectrum of HIV associated malignancies in this region. The raised PIR for cervical cancer emphasizes the urgent need for screening programs for cervical cancer among HIV infected individuals in India.