Increased Incidence of Cancer among Homosexual Men, New York City and San Francisco, 1978-1990

Abstract

Several studies have shown that human immunodeficiency virus type 1 (HIV-1) is associated with an increase in the incidence of Kaposi's sarcoma and non-Hodgkin's lymphoma among homosexual men. The role of HIV-1 in increasing the incidence of other malignancies is more controversial. The incidence of non-Kaposi's sarcoma cancer was examined from 1978 to 1990 among 15, 565 homosexual men who participated in studies of hepatitis B virus infection in the late 1970s in New York City, New York, and San Francisco, California. The standardized incidence ratio (SIR) for all cancers was 1.6 (95% confidence interval (Cl) 1.4–1.8). Excesses were observed for non-Hodgkin's lymphoma (SIR = 12.7; 95% Cl 11.0–14.6), Hodgkin's disease (SIR = 2.5; 95% Cl 1.5–3.9), and anal cancer (SIR = 24.2; 95% Cl 13.5–39.9). As seen with non-Hodgkin's lymphoma, a cancer known to be associated with HIV-1, Hodgkin's disease incidence was significantly higher in more recent years compared with earlier years. No cases of Hodgkin's disease were found among HIV-1 antibody-negative men, and Hodgkin's disease was diagnosed near the time of initial acquired immunodeficiency syndrome diagnoses. Anal cancer incidence did not correlate with HIV-1 antibody status and did not tend to occur near the time of AIDS diagnoses. This study confirms the association of non-Hodgkin's lymphoma with HIV-1 infection and suggests an association between Hodgkin's disease and HIV-1 infection. An excess in anal cancer was observed but did not appear to be associated with HIV-1 infection. Am J Epidemiol 1996; 144: 916-23.