Data on colorectal cancer in HIV-positive patients are limited.
Dr Nir Westerberg and colleagues from Israel investigated the incidence, presentation, and outcome of colorectal cancer in HIV patients.
The team diagnosed clinical data on patients with colorectal cancer and concurrent HIV/AIDS infection between 1994 and 2003 from the institutional records.
Each identified patient was randomly matched with 2 HIV-negative colorectal cancer patients based on age, sex, race, and TNM stage at cancer diagnosis.
The team assessed presentation, treatment toxicities, recurrence, and overall survival rates.
|90% of the patients had advanced stages 3 to 4 at diagnosis|
The research team compared data with those of the published international Surveillance Epidemiology and End Results data.
The researchers identified out of 3,951 colorectal cancer patients, 12 HIV colorectal cancer patients.
Median age at cancer diagnosis was 41 years, revealing a 3:1 ratio between patients younger and older then 50 years, compared to a 1:33 ratio in the general population.
The team found that 90% of the patients had advanced stages 3 to 4 at diagnosis.
The team observed that median follow-up time for both cases and controls was 30 months.
HIV-positive patients had a shorter disease-free survival than the controls.
No difference in overall survival was demonstrated.
However, the team noted that survival was significantly reduced in the HIV-positive patients when only patients who were initially disease-free were compared.
Adjuvant therapy was well-tolerated in all patients without chemotherapy-related deaths.
Dr Wasserberg's team concluded, "HIV-positive colorectal cancer patients tend to have an early and more aggressive presentation with less favorable outcome."
" Further epidemiology studies to refute or accept our observations may suggest a reduced threshold for screening for colorectal cancer in HIV-positive patients."