Primary lung cancer diagnoses in people living with HIV in a large clinical centre in Montreal, Canada over 3 decades

AIDS Care. 2020 Aug;32(8):979-983. doi: 10.1080/09540121.2020.1758614. Epub 2020 May 6.


Lung cancer is the most frequent type of cancer-related death in people living with HIV (PLWH). We conducted a review of primary lung cancers in PLWH at the McGill University Health Centre from 1988-May 2018 to understand potential factors contributing to their development prior to the implementation of a lung cancer screening program. Twenty-seven individuals had a diagnosis of a lung tumor. Of these individuals, 21 (78%) had a primary lung cancer, over 21,428 person-years follow-up. Median age was 54.5 years [25th and 75th percentiles 49.0, 62.0]. Median CD4 count was 185.0 cells/μL [25th and 75th percentiles 54.0, 446.0] and 52% were on antitretroviral therapy with suppressed viral loads. Type of primary lung cancer included: non-small cell lung cancer (n = 15), small-cell lung cancer (n = 4) and bronchial carcinomas (n = 2). Metastatic disease at diagnosis was present in 11 (52%) persons. Survival was a median of 7.5 months from the time of diagnosis [25th and 75th percentiles 2.0, 9.0]. In conclusion, we observed a high proportion of lung cancers detected at very late stages of disease and with metastatic involvement. The implementation of a lung cancer screening program in 2018 should set a stage shift for earlier diagnosis and treatment.

Keywords: HIV; Lung cancer; clinical improvement; co-morbidity; lung cancer screening.

Publication types

  • Review

MeSH terms

  • CD4 Lymphocyte Count
  • Canada / epidemiology
  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Carcinoma, Non-Small-Cell Lung / epidemiology
  • Comorbidity
  • Early Detection of Cancer
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / epidemiology
  • Middle Aged