Lung cancer in the Swiss HIV Cohort Study: role of smoking, immunodeficiency and pulmonary infection

Br J Cancer. 2012 Jan 31;106(3):447-52. doi: 10.1038/bjc.2011.558. Epub 2012 Jan 12.

Abstract

Background: Immunodeficiency and AIDS-related pulmonary infections have been suggested as independent causes of lung cancer among HIV-infected persons, in addition to smoking.

Methods: A total of 68 lung cancers were identified in the Swiss HIV Cohort Study (SHCS) or through linkage with Swiss Cancer Registries (1985-2010), and were individually matched to 337 controls by centre, gender, HIV-transmission category, age and calendar period. Odds ratios (ORs) were estimated by conditional logistic regression.

Results: Overall, 96.2% of lung cancers and 72.9% of controls were ever smokers, confirming the high prevalence of smoking and its strong association with lung cancer (OR for current vs never=14.4, 95% confidence interval (95% CI): 3.36-62.1). No significant associations were observed between CD4+ cell count and lung cancer, neither when measured within 1 year (OR for <200 vs ≥500=1.21, 95% CI: 0.49-2.96) nor further back in time, before lung cancer diagnosis. Combined antiretroviral therapy was not significantly associated with lung cancer (OR for ever vs never=0.67, 95% CI: 0.29-1.52), and nor was a history of AIDS with (OR=0.49, 95% CI: 0.19-1.28) or without (OR=0.53, 95% CI: 0.24-1.18) pulmonary involvement.

Conclusion: Lung cancer in the SHCS does not seem to be clearly associated with immunodeficiency or AIDS-related pulmonary disease, but seems to be attributable to heavy smoking.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / complications*
  • Adult
  • Aged
  • CD4 Lymphocyte Count
  • Case-Control Studies
  • Cohort Studies
  • Female
  • HIV Infections / complications*
  • HIV Infections / immunology
  • Humans
  • Immunocompromised Host
  • Lung Diseases / complications
  • Lung Neoplasms / epidemiology*
  • Lung Neoplasms / etiology
  • Male
  • Middle Aged
  • Odds Ratio
  • Prevalence
  • Smoking / adverse effects*
  • Switzerland / epidemiology