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Hodgkin’s Disease, Lip Cancer, Testicular Cancer in AIDS Patients May be Related to Immunosuppression
Hodgkin's disease, lip cancer and a form of testicular cancer in patients with AIDS may be related to immunosuppression, according to a study conducted by researchers from the National Cancer Institute and the Danish Epidemiology Science Center and reported in today's Journal of the American Medical Association, AP/Nando Times reports. Non-Hodgkin's lymphoma, cervical cancer and
Kaposi's sarcoma, a form of skin cancer, are already classified as "AIDS-defining diseases." In addition to these cancers, researchers found that AIDS patients were 11 times more likely than those without AIDS to have Hodgkin's disease, three times more likely to have lip cancer and twice as likely to have a form of testicular cancer (AP/Nando Times, 4/3). Using data from the
AIDS-Cancer Match Registry Study from 1979 to 1996, researchers led by Dr. Morton Frisch studied 302,834 AIDS patients from 11 geographical areas ranging in age from 15 to 69. "Relative risks" of cancer were calculated by dividing the number of observed cancer cases by the number of expected cases, based on "contemporaneous population-based incidence rates." Cancers "potentially influenced by immunosuppression" had to meet three criteria: elevated RR in the time span of 60 months before to 27 months after AIDS diagnosis, elevated RR in the 4- to 27-month post-AIDS diagnosis period and "increasing trend" in RR from before to after the onset of AIDS. Researchers found "[e]xpected excesses" of the AIDS-defining cancers, but Hodgkin's disease, lung cancer, soft tissue malignancies, penile cancer and a type of testicular cancer also met all three criteria. After analysis of the results, researchers concluded that lung cancer, penile cancer and soft tissue malignancies may be due to
"lifestyle-related" factors linked to cancer risk "independently of immunosuppression," such as "heavy" smoking, "frequent exposure" to human papillomavirus and misdiagnoses of Kaposi's sarcoma. However, Hodgkin's disease and "possibly" lip cancer and testicular cancer may be "genuinely influenced by immunosuppression" related to AIDS, the researchers said. The Hodgkin's findings are "consistent" with "several smaller studies" and met the researchers' immunodeficiency-related criteria in "all major strata of sex, race and HIV exposure." The researchers concluded that these findings "show that the risk of Hodgkin's disease increases with advancing immunosuppression and suggest it be considered as an AIDS-defining condition" (Frisch et al., JAMA, 4/3).
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