Cancer Stage at Diagnosis in Transplant Recipients and Patients with HIV Infection

Hensin Tsao, MD, PhD reviewing Shiels MS et al. Cancer 2015 Mar 4.

Melanoma and bladder cancer were more likely to be diagnosed at an advanced stage in both HIV-infected individuals and organ transplant recipients.

Melanomas are known to be an immune-responsive cancer. Many studies have examined the effects of immune suppression on melanoma risk. Now, an analysis of cancer risk among immunocompromised individuals produces some interesting findings.

To determine whether immunosuppression results in more aggressive, advanced-stage cancers, the investigators analyzed data from cancer, human immunodeficiency virus (HIV), and solid-organ transplant registries. They found 8411 cancer cases in HIV-infected individuals and 7322 cancer cases in transplant recipients. Compared with immunocompetent cancer patients, the immunosuppressed patients were more likely to have advanced stage melanoma and bladder cancer at diagnosis. The risk for melanoma was similar in uninfected cancer patients and those with HIV, but transplant patients had a higher risk. Other cancers (lung, breast, prostate) were also more advanced at diagnosis in HIV-infected patients than in immunocompetent patients, but they were less advanced in the transplant recipients. This difference, the authors suggest, reflects better access to care for the transplant patients.

Citation(s):

Shiels MS et al. Cancer stage at diagnosis in patients infected with the human immunodeficiency virus and transplant recipients. Cancer 2015 Mar 4; [e-pub].