Decreasing Incidence of Conjunctival Squamous Cell Carcinoma in People with HIV in South Africa.

Metekoua, Carole; Ruffieux, Yann; Olago, Victor; Dhokotera, Tafadzwa; Egger, Matthias; Bohlius, Julia; Rohner, Eliane; Muchengeti, Mazvita (2023). Decreasing Incidence of Conjunctival Squamous Cell Carcinoma in People with HIV in South Africa. Journal of the National Cancer Institute JNCI, 115(10), pp. 1213-1219. Oxford University Press 10.1093/jnci/djad119

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BACKGROUND

The main risk factors for squamous cell carcinoma of the conjunctiva (SCCC) are immunodeficiency and exposure to ultraviolet radiation. Little is known about the SCCC epidemiology among people with HIV (PWH) in South Africa.

METHODS

We used data from the South African HIV Cancer Match study, a nation-wide cohort of PWH in South Africa, created through a privacy-preserving probabilistic record linkage of HIV-related laboratory records from the National Health Laboratory Service and cancer records from the National Cancer Registry from 2004-2014. We calculated crude incidence rates, analyzed trends using Joinpoint models and estimated hazard ratios (HR) for different risk factors using Royston-Parmar flexible parametric survival models.

FINDINGS

Among 5,247,968 PWH, 1,059 incident SCCC were diagnosed for a crude overall SCCC incidence rate of 6.8/100,000 person-years. The SCCC incidence rate decreased between 2004 and 2014 with an annual percentage change of -10.9% (95% CI -13.3 to -8.3). PWH residing within latitudes 30°S-34°S had a 49% lower SCCC risk than those residing at < 25°S (adjusted HR 0.67; 95% CI 0.55-0.82). Other risk factors for SCCC were lower CD4 counts and middle-age. There was no evidence for an association of sex or settlement type with SCCC risk.

INTERPRETATION

An increased risk of developing SCCC was associated with lower CD4 counts and residence closer to the equator, indicative of higher ultraviolet exposure. Clinicians and PWH should be educated on known SCCC preventive measures such as maintaining high CD4 counts and protection from ultraviolet radiation through sunglasses and sunhats when outdoors.

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 Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Ruffieux, Yann, Dhokotera, Tafadzwa Gladys, Egger, Matthias, Bohlius, Julia Friederike, Rohner, Eliane

Subjects:

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

ISSN:

0198-0157

Publisher:

Oxford University Press

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Pubmed Import

Date Deposited:

29 Jun 2023 10:24

Last Modified:

30 Jun 2024 00:25

Publisher DOI:

10.1093/jnci/djad119

PubMed ID:

37379162

Additional Information:

Eliane Rohner and Mazvita Muchengeti contributed equally to this work.

Uncontrolled Keywords:

HIV/AIDS South Africa conjunctival cancer incidence squamous cell carcinoma

BORIS DOI:

10.48350/184223

URI:

https://boris.unibe.ch/id/eprint/184223

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