biostudies-literatureShiels MSIntramural NIH HHSNCCDPHP CDC HHSNCHHSTP CDC HHSNCI NIH HHSPHS HHS2063-71https://www.ebi.ac.uk/biostudies/studies/S-EPMC4470321biostudies-literatureUnknown121(12)BACKGROUND:It is unknown whether immunosuppression results in more aggressive, advanced stage cancers. Because cancer stage is influenced both by tumor biology and medical surveillance, the authors assessed cancer stage in individuals infected with the human immunodeficiency virus (HIV) and solid organ transplant recipients, 2 immunosuppressed groups with differences in their health care use. METHODS:The authors used data on all cases of 15 cancer types diagnosed during 1996 through 2010 in 2 studies that linked US cancer registries with HIV and transplant registries. Odds ratios (ORs) for advanced (vs local) disease were estimated comparing HIV and transplant populations with immunocompetent individuals in polytomous logistic regression models adjusted for age, sex, race, registry, and year. RESULTS:A total of 8411 of 4.5 million cancer cases occurred in HIV-infected individuals and 7322 of 6.4 million cancer cases occurred in transplant recipients. Compared with immunocompetent patients with cancer, those infected with HIV were more likely to be diagnosed with distant stage lung (OR, 1.13), female breast (OR, 1.99), and prostate (OR, 1.57) cancers, whereas transplant recipients had fewer distant stage lung (OR, 0.54), female breast (OR, 0.75), and prostate (OR, 0.72) cancers. Both immunosuppressed populations had a shift toward advanced stage melanoma (ORs of 1.97 for HIV-infected individuals and 1.82 for transplant recipients) and bladder cancer (ORs of 1.42 for HIV-infected individuals and 1.54 for transplant recipients). CONCLUSIONS:Bladder cancer and melanoma were more likely to be diagnosed at a nonlocal stage in both HIV-infected individuals and transplant recipients, suggesting a role for immunosuppression in their progression. In addition, we observed a shift for some common cancers toward later stages in HIV-infected individuals and toward earlier stages in transplant recipients, which is consistent with differential access to medical care or surveillance.CancerCancer stage at diagnosis in patients infected with the human immunodeficiency virus and transplant recipients.PMC4470321U58 DP0008325U62PS004011-02U62 PS004011Z99 CA999999N01PC35137N01PC35139HHSN261201000024CHHSN261201000037CP30 CA086862U62 PS0040155U58DP003921-0301000024CU58 DP003879HHSN261201000035IU58DP000832U58 DP003875HHSN261201000035CHHSN261201000036CHSN261201000032CN01-PC-2013-00021U58 DP003921U58 DP003920U58DP003879HHSN2612010000HHSN261201000034CU58 DP003883U62 PS001005U62PS004001-2N01-PC-35142U58 DP000848U58 DP000807HHSN2612HHSH234200537009CN01-PC-35143U58 DP003931U58 DP000848-045U62PS0040155U58DP003875-015U58DP003883-03HHSH250201000018CU58 DP000824U62 PS004001HHSN261201300021C5U62PS001005-0HHSN261201300021IN01-PC-35139HHSN261201000026CN01PC351435U58/DP003931-02N01PC351425U58DP000824-04U58DP12-1205 3919-031U58 DP000807-015458DP003920N01-PC-35137Copeland GPawlish KHarrell JShiels MSPfeiffer RMEngels EALynch CFGoodman MTfalseCancer stage at diagnosis in patients infected with the human immunodeficiency virus and transplant recipients.BACKGROUND:It is unknown whether immunosuppression results in more aggressive, advanced stage cancers. Because cancer stage is influenced both by tumor biology and medical surveillance, the authors assessed cancer stage in individuals infected with the human immunodeficiency virus (HIV) and solid organ transplant recipients, 2 immunosuppressed groups with differences in their health care use. METHODS:The authors used data on all cases of 15 cancer types diagnosed during 1996 through 2010 in 2 studies that linked US cancer registries with HIV and transplant registries. Odds ratios (ORs) for advanced (vs local) disease were estimated comparing HIV and transplant populations with immunocompetent individuals in polytomous logistic regression models adjusted for age, sex, race, registry, and year. RESULTS:A total of 8411 of 4.5 million cancer cases occurred in HIV-infected individuals and 7322 of 6.4 million cancer cases occurred in transplant recipients. Compared with immunocompetent patients with cancer, those infected with HIV were more likely to be diagnosed with distant stage lung (OR, 1.13), female breast (OR, 1.99), and prostate (OR, 1.57) cancers, whereas transplant recipients had fewer distant stage lung (OR, 0.54), female breast (OR, 0.75), and prostate (OR, 0.72) cancers. Both immunosuppressed populations had a shift toward advanced stage melanoma (ORs of 1.97 for HIV-infected individuals and 1.82 for transplant recipients) and bladder cancer (ORs of 1.42 for HIV-infected individuals and 1.54 for transplant recipients). CONCLUSIONS:Bladder cancer and melanoma were more likely to be diagnosed at a nonlocal stage in both HIV-infected individuals and transplant recipients, suggesting a role for immunosuppression in their progression. In addition, we observed a shift for some common cancers toward later stages in HIV-infected individuals and toward earlier stages in transplant recipients, which is consistent with differential access to medical care or surveillance.2015-01-01T00:00:00Z2015 Jun2020-10-29T14:16:28Z2019-03-27T01:53:34ZS-EPMC44703212573949610.1002/cncr.29324