Association Between Educational Level and Risk of Cancer in HIV-infected Individuals and the Background Population: Population-based Cohort Study 1995-2011

Rebecca Legarth, Lars H Omland, Susanne O Dalton, Gitte Kronborg, Carsten S Larsen, Court Pedersen, Gitte Pedersen, Jan Gerstoft, Niels Obel

1 Citation (Scopus)

Abstract

BACKGROUND: Human immunodeficiency virus (HIV)-infected individuals have increased risk of cancer. To our knowledge, no previous study has examined the impact of socioeconomic position on risk and prognosis of cancer in HIV infection.

METHODS: Population-based cohort-study, including HIV-infected individuals diagnosed (without intravenous drug abuse or hepatitis C infection) (n = 3205), and a background population cohort matched by age, gender, and country of birth (n = 22 435) were analyzed. Educational level (low or high) and cancer events were identified in Danish national registers. Cumulative incidences, incidence rate ratios (IRRs), and survival using Kaplan-Meier methods were estimated.

RESULTS: Low educational level was associated with increased risk of cancer among HIV-infected individuals compared to population controls: all (adjusted-IRRs: 1.4 [95% confidence interval {CI}, 1.1-1.7] vs 1.1 [95% CI, .9-1.2]), tobacco- and alcohol-related (2.1 [95% CI, 1.3-3.4] vs 1.3 [95% CI, 1.1-1.6]), and other (1.7 [95% CI, 1.1-2.8] vs 0.9 [95% CI, .7-1.0]). Educational level was not associated with infection-related or ill-defined cancers. One-year-survival was not associated with educational level, but HIV-infected individuals with low educational level had lower 5-year-survival following infection-related and ill-defined cancers.

CONCLUSIONS: Education is associated with risk and prognosis of some cancers in HIV infection, and diverges from what is observed in the background population.

Original languageEnglish
JournalThe Journal of infectious diseases
Volume212
Issue number10
Pages (from-to)1552-62
Number of pages11
ISSN0022-1899
DOIs
Publication statusPublished - 15 Nov 2015

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