The spectrum of malignancies in HIV-infected patients in 2006 in France: the ONCOVIH study

Since no large descriptive studies of incident cancers in HIV-infected patients are available in France, the nationwide cross-sectional ONCOVIH study aimed to prospectively report new malignancies diagnosed in HIV-infected patients in cancer centers and HIV/AIDS centers. We estimated the number of cancers in France for the year 2006 using the capture-recapture methods with two sources: ONCOVIH and the FHDH ANRS-CO4 cohort, as well as the completeness of the sources. Incidence and relative risks (RR) to the general population were estimated. In 2006, 672 new malignancies in 668 patients were reported in ONCOVIH; the most common were non Hodgkin's lymphoma (NHL, 21.5%), Kaposi's sarcoma (KS, 16.0%), lung cancer (9.4%), anal cancer (8.2%), Hodgkin's lymphoma (7.6%), skin cancers excluding melanoma (6.8%), and liver cancer (5.6%). Based on the capture-recapture approach, the estimated number of malignancies was 1320 and non-AIDS-defining malignancies (NADM) represented 68% of cases. The overall ascertainment of malignancies were 53%, and 59%, in the ONCOVIH study, and the FHDH ANRS-CO4 cohort, respectively. The estimated incidence of cancer among HIV-infected patients was 14 per 1000 person-years. Compared with the general population, the estimated RR in HIV-infected patients was 3.5 (95% CI 3.3-3.8) in men and 3.6 (95% CI 3.2-4.0) in women, and was particularly elevated in younger patients. Even in the era of combined antiretroviral therapy, the incidence of cancer is higher in HIV-infected persons than in the general population. A large variety of malignancies were diagnosed, and the majority were NADM.