Objectives: Among people with HIV (PWH), the epidemiology of malignant tumors has shifted from AIDS-defining malignancies (ADMs) to non-AIDS-defining malignancies (NADMs). This study examined temporal changes in the standardized incidence ratio (SIR) of malignant tumors in an HIV cohort in Japan.Methods: A retrospective cohort study was conducted of 3793 men treated for HIV at Osaka National Hospital between 2007 and 2024. Diagnoses of malignant tumors were identified from medical records and the expected numbers of cases were calculated using cancer incidence rates for the general male population of Japan. SIRs and 95% confidence intervals (CIs) were calculated and temporal changes across four periods (2007–2011, 2012–2016, 2017–2020, and 2021–2024) were evaluated using thepfor trend.Results: The overall SIR for malignant tumors decreased from 5.12 (95% CI: 4.02–6.43) in 2007–2011 to 0.86 (95% CI: 0.64–1.14) in 2021–2024, mainly owing to a decline in ADMs (SIR: 111.93 to 5.70), including Kaposi’s sarcoma (SIR: 4269.39 to 547.26) and AIDS-related lymphoma (SIR: 62.18 to 3.13). The overall SIR for NADMs was similar to that of the general population (1.04; 95% CI: 0.89–1.22), and decreased from 1.64 to 0.69, but the risks of anal cancer (SIR 40.63) and oral/pharyngeal cancer (SIR 3.16) remained high.Conclusions: Among men with HIV in Japan, the overall risk of ADMs and NADMs has decreased; however, the risk of specific NADMs remains high. Cancer prevention strategies for PWH need to focus on high-risk NADMs.
目的：在HIV感染者中，恶性肿瘤的流行病学特征已从艾滋病定义性恶性肿瘤（ADMs）转向非艾滋病定义性恶性肿瘤（NADMs）。本研究旨在探讨日本HIV感染者队列中恶性肿瘤标准化发病比（SIR）的时间变化趋势。方法：对2007年至2024年间在大阪国立医院接受治疗的3793名男性HIV感染者开展回顾性队列研究。通过医疗记录确认恶性肿瘤诊断，并依据日本普通男性人群的癌症发病率计算预期病例数。计算SIR及95%置信区间，并基于趋势p值评估四个时期（2007–2011年、2012–2016年、2017–2020年、2021–2024年）的时间变化。结果：恶性肿瘤总SIR从2007–2011年的5.12（95% CI：4.02–6.43）下降至2021–2024年的0.86（95% CI：0.64–1.14），主要归因于ADMs的下降（SIR从111.93降至5.70），包括卡波西肉瘤（SIR从4269.39降至547.26）和艾滋病相关淋巴瘤（SIR从62.18降至3.13）。NADMs的总SIR与普通人群相近（1.04；95% CI：0.89–1.22），从1.64降至0.69，但肛门癌（SIR 40.63）和口咽癌（SIR 3.16）的风险仍居高不下。结论：在日本男性HIV感染者中，ADMs与NADMs的总体风险已下降，但特定NADMs的风险仍然较高。针对HIV感染者的癌症预防策略需重点关注高危型NADMs。
Cancer Risk in Men with HIV in Japan: An 18-Year Single-Center Cohort Study
肿瘤(癌症)患者之家