THE ROLE OF HIV IN LUNG CANCER: A CASE CONTROL STUDY IN BLACK SOUTH AFRICANS, 2001-2008
Lung cancer is a recognised HIV-associated cancer in developed countries. This association has not been confirmed in African populations. There is therefore need to explore associations between HIV and lung cancer in black South Africans.
METHODS:
Data from the on-going Johannesburg Cancer Case-Control Study (JCCCS) of black African adult cancer patients (2001-2008) was used. Information from 579 lung cancer cases and 1120 frequency matched controls was analysed. Controls were randomly selected from cancers not known to be associated with the effects of tobacco, matched by sex and age (±5years).Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression. All patients were independently tested for HIV-1 using a single ELISA test.
RESULTS:
Overall 85% of lung cancers and 62% of controls were smokers, confirming high prevalence of smoking and its association with lung cancer (OR= 5.8 (95% CI 4.6 – 6.4). Overall HIV prevalence was 32% i.e. 13 % in cases and 41% in controls.HIV infection was associated with having lung cancer (OR= 1.8 (95% CI 1.2 - 2.6) after adjusting for smoking, alcohol intake and domestic fuel use.
CONCLUSIONS:
Lung cancer might be associated with HIV in black South Africans. Irrespective of causality and mechanisms, lung cancer represents an important growing problem confronting HIV infected patients and their providers. Substantial efforts are needed to promote smoking cessation and to control lung cancer amongst HIV infected population.