Cancer incidence among people living with HIV in Zimbabwe: A record linkage study.

Shamu, Tinei; Rohner, Eliane; Chokunonga, Eric; Spoerri, Adrian; Mandiriri, Ardele; Chimbetete, Cleophas; Egger, Matthias; Bohlius, Julia; Borok, Margaret (2022). Cancer incidence among people living with HIV in Zimbabwe: A record linkage study. Cancer reports, 5(10), e1597. Wiley 10.1002/cnr2.1597

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BACKGROUND

People living with HIV (PLWH) are at increased risk of developing cancer. Cancer diagnoses are often incompletely captured at antiretroviral therapy (ART) clinics.

AIM

To estimate the incidence and explore risk factors of cancer in a cohort of PLWH in Harare using probabilistic record linkage (PRL).

METHODS

We conducted a retrospective cohort study that included PLWH aged ≥16 years starting ART between 2004 and 2017. We used PRL to match records from the Zimbabwe National Cancer Registry (ZNCR) with electronic medical records from an ART clinic in Harare to investigate the incidence of cancer among PLWH initiating ART. We matched records based on demographic data followed by manual clerical review. We followed PLWH up until first cancer diagnosis, death, loss to follow-up, or 31 December 2017, whichever came first.

RESULTS

We included 3442 PLWH (64.9% female) with 19 346 person-years (PY) of follow-up. Median CD4 count at ART initiation was 169 cells/mm3 (interquartile range [IQR]: 82-275), median age was 36.6 years (IQR: 30.6-43.4). There were 66 incident cancer cases for an overall incidence rate of 341/100 000 PY (95% confidence interval [CI]: 268-434). Twenty-two of these cases were recorded in the ZNCR only. The most common cancers were cervical cancer (n = 16; 123/100 000 PY; 95% CI: 75-201), Kaposi sarcoma, and lymphoma (both n = 12; 62/100 000 PY; 95% CI: 35-109). Cancer incidence increased with age and decreased with higher CD4 cell counts at ART initiation.

CONCLUSION

PRL was key to correct for cancer under-ascertainment in this cohort. The most common cancers were infection-related types, reinforcing the role of early HIV treatment, human papillomavirus vaccination, and cervical cancer screening for cancer prevention in this setting.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Shamu, Tinei, Rohner, Eliane, Spörri, Adrian, Egger, Matthias, Bohlius, Julia Friederike

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2573-8348

Publisher:

Wiley

Language:

English

Submitter:

Beatrice Minder Wyssmann

Date Deposited:

13 Dec 2021 19:49

Last Modified:

05 Dec 2022 15:56

Publisher DOI:

10.1002/cnr2.1597

PubMed ID:

34873875

Uncontrolled Keywords:

HIV Zimbabwe cancer incidence record linkage

BORIS DOI:

10.48350/162344

URI:

https://boris.unibe.ch/id/eprint/162344

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