TY - JOUR
T1 - Association between educational level and risk of cancer in HIV-infected individuals and the background population
T2 - Population-based cohort study 1995-2011
AU - Legarth, Rebecca
AU - Omland, Lars H.
AU - Dalton, Susanne O.
AU - Kronborg, Gitte
AU - Larsen, Carsten S.
AU - Pedersen, Court
AU - Pedersen, Gitte
AU - Gerstoft, Jan
AU - Obel, Niels
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Background. Human immunodeficiency virus (HIV)-infected individuals have increased risk of cancer. To our knowledge, no previous study has examined the impact of socioeconomic position on risk and prognosis of cancer in HIV infection. Methods. Population-based cohort-study, including HIV-infected individuals diagnosed (without intravenous drug abuse or hepatitis C infection) (n = 3205), and a background population cohort matched by age, gender, and country of birth (n = 22 435) were analyzed. Educational level (low or high) and cancer events were identified in Danish national registers. Cumulative incidences, incidence rate ratios (IRRs), and survival using Kaplan-Meier methods were estimated. Results. Low educational level was associated with increased risk of cancer among HIV-infected individuals compared to population controls: All (adjusted-IRRs: 1.4 [95% confidence interval {CI}, 1.1-1.7] vs 1.1 [95% CI, .9-1.2]), tobacco-And alcohol-related (2.1 [95% CI, 1.3-3.4] vs 1.3 [95% CI, 1.1-1.6]), and other (1.7 [95% CI, 1.1-2.8] vs 0.9 [95% CI, .7-1.0]). Educational level was not associated with infection-related or ill-defined cancers. One-year-survival was not associated with educational level, but HIV-infected individuals with low educational level had lower 5-yearsurvival following infection-related and ill-defined cancers. Conclusions. Education is associated with risk and prognosis of some cancers in HIV infection, and diverges from what is observed in the background population.
AB - Background. Human immunodeficiency virus (HIV)-infected individuals have increased risk of cancer. To our knowledge, no previous study has examined the impact of socioeconomic position on risk and prognosis of cancer in HIV infection. Methods. Population-based cohort-study, including HIV-infected individuals diagnosed (without intravenous drug abuse or hepatitis C infection) (n = 3205), and a background population cohort matched by age, gender, and country of birth (n = 22 435) were analyzed. Educational level (low or high) and cancer events were identified in Danish national registers. Cumulative incidences, incidence rate ratios (IRRs), and survival using Kaplan-Meier methods were estimated. Results. Low educational level was associated with increased risk of cancer among HIV-infected individuals compared to population controls: All (adjusted-IRRs: 1.4 [95% confidence interval {CI}, 1.1-1.7] vs 1.1 [95% CI, .9-1.2]), tobacco-And alcohol-related (2.1 [95% CI, 1.3-3.4] vs 1.3 [95% CI, 1.1-1.6]), and other (1.7 [95% CI, 1.1-2.8] vs 0.9 [95% CI, .7-1.0]). Educational level was not associated with infection-related or ill-defined cancers. One-year-survival was not associated with educational level, but HIV-infected individuals with low educational level had lower 5-yearsurvival following infection-related and ill-defined cancers. Conclusions. Education is associated with risk and prognosis of some cancers in HIV infection, and diverges from what is observed in the background population.
KW - cancer
KW - Educational level
KW - HIV infection; mortality
UR - http://www.scopus.com/inward/record.url?scp=84956594230&partnerID=8YFLogxK
U2 - 10.1093/infdis/jiv247
DO - 10.1093/infdis/jiv247
M3 - Article
C2 - 25904603
AN - SCOPUS:84956594230
SN - 0022-1899
VL - 212
SP - 1552
EP - 1562
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 10
ER -