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Risk of Colorectal Cancer and Associated Mortality in HIV: A Systematic Review and Meta-Analysis.

Risk of Colorectal Cancer and Associated Mortality in HIV: A Systematic Review and Meta-Analysis.
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OʼNeill TJ, Nguemo JD, Tynan AM, Burchell AN, Antoniou T,


OʼNeill TJ, Nguemo JD, Tynan AM, Burchell AN, Antoniou T, (click to view)

OʼNeill TJ, Nguemo JD, Tynan AM, Burchell AN, Antoniou T,

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Journal of acquired immune deficiency syndromes (1999) 75(4) 439-447 doi 10.1097/QAI.0000000000001433

Abstract
BACKGROUND
As people with HIV live longer, the numbers of colorectal cancer cases are expected to increase. We sought to compare the colorectal cancer incidence and cause-specific mortality among people living with and without HIV.

DESIGN
Systematic review and meta-analysis.

METHODS
We searched 5 electronic databases up to June 28, 2016, for primary studies reporting standardized incidence ratios (SIRs), standardized mortality ratios (SMRs)/hazard ratios or data sufficient for estimating these summary measures. We performed a random effects pooled analysis to estimate SIR and SMR of colorectal cancer in HIV.

RESULTS
Of 8110 articles, we included 27 studies from North America (n = 18), Europe (n = 7), the Pacific region (n = 4), and South America (n = 1). Overall, 1660 cases of colorectal cancer and colon cancer (excluding rectal cancer) occurred among 1,696,070 persons with HIV. In pooled analysis, we found no summary risk of malignancy among those with HIV relative to an uninfected population (SIR 1.00; 95% confidence interval 0.82 to 1.22; I = 89.2%). Colorectal cancer-specific mortality was higher among people with HIV but did not reach statistical significance (SMR 2.09; 95% confidence interval: 1.00 to 4.40; I = 85.0%).

CONCLUSIONS
Rates of colorectal cancer are similar between people with and without HIV. Existing screening guidelines are likely adequate for people with HIV.

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