Differences in Trends in Cancer Incidence Rates Among People with HIV during 2001-2019 By Race and Ethnicity and By Risk Group in the United States

Cancer risk among people with HIV (PWH) has declined over time as a result of antiretroviral therapy, but it is unclear whether all racial/ethnic groups and transmission risk groups have experienced equal declines. We used data on PWH aged ≥20 years old from the HIV/AIDS Cancer Match Study during 2001-2019. We used Poisson regression to assess time trends in incidence rates for each cancer site by racial/ethnicity and risk group, adjusting for age, registry, and sex. We also estimated adjusted rate ratios across racial and ethnic and risk groups in 2001-2004 and 2015-2019. Trends in age-standardized rates differed across Black, White and Hispanic PWH, and across risk groups for some cancers. For example, liver cancer rates declined 23% per 5-year period among White PWH, 11% in Black PWH and 18% in Hispanic PWH. Anal cancer rates declined among men who have sex with men, were stable among people who inject drugs, and increased among other risk groups Between 2001-2004 and 2015-2019, relative difference in cancer incidence rates by race/ethnicity increased for HL and liver cancer but decreased for NHL; by risk group, relative differences increased for NHL and liver cancer, and decreased for HL, lung and anal cancers. Among PWH in the US, during 2001-2019, HL, lung, liver, and cervical cancer rate trends were different across racial/ethnic groups. HL, lung, anal, and liver cancer rates trends were different across risk groups. Future work should examine underlying causes of the differences in trends.