Observational studyJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2014
Prospective CT screening for lung cancer in a high-risk population: HIV-positive smokers.
Observational study in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 51 citations in OpenAlex.
- Cancer Screening Behaviors among People with HIV in the United States and the Role of Multi-Level Social and Economic Factors: A Systematic Review.Current epidemiology reports · 2026Article
- Early Detection of Cancer and Precancerous Lesions in Persons With HIV Through a Comprehensive Cancer Screening Protocol.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Cancer screening in people living with HIV.Cancer medicine · 2023Review
- Lung cancer screening adherence among people living with and without HIV: An analysis of an integrated health system in Florida, United States (2012-2021).Preventive medicine reports · 2023Article
- Trends and risk of lung cancer among people living with HIV in the USA: a population-based registry linkage study.The lancet. HIV · 2022Article
- Article
- Ventilation Heterogeneity and Its Association with Nodule Formation Among Participants in the National Lung Screening Trial-A Preliminary Investigation.Academic radiology · 2020Article
- Disparities in Lung Cancer Screening: A Review.Annals of the American Thoracic Society · 2020Review
- Short-term outcomes for lung cancer resection surgery in HIV infection.AIDS (London, England) · 2019Article
- Cancer prevention in patients with human immunodeficiency virus infection.World journal of clinical oncology · 2018Article
- Benefits and harms of lung cancer screening in HIV-infected individuals with CD4+ cell count at least 500 cells/μl.AIDS (London, England) · 2018Article
- HIV-Associated Cancers and Related Diseases.The New England journal of medicine · 2018Review
- Cancer screening in women living with HIV infection.Women's health (London, England) · 2017Article
- Lung cancer in persons with HIV.Current opinion in HIV and AIDS · 2017Review
- Non-infectious Pulmonary Diseases and HIV.Current HIV/AIDS reports · 2016Review
- Lung Malignancies in HIV Infection.Seminars in respiratory and critical care medicine · 2016Review
- Maintaining lung health with longstanding HIV.Current opinion in infectious diseases · 2016Review
- Cancer prevention in HIV-infected populations.Seminars in oncology · 2016Review
- Lung cancer in HIV-infected patients in the combination antiretroviral treatment era.Translational lung cancer research · 2015Review
- A Review of Chronic Comorbidities in Adults Living With HIV: State of the Science.The Journal of the Association of Nurses in AIDS Care : JANACReview
Corrections and comments
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Authors and funding
28 authors at 1 institution in 1 country.
Funding
Abstract
backgroundEpidemiological evidence suggests that HIV-infected individuals are at increased risk of lung cancer, but no data exist because large computed tomography (CT) screening trials routinely exclude HIV-infected participants.
methodsFrom 2006 to 2013, we conducted the world's first lung cancer screening trial of 224 HIV-infected current/former smokers to assess the CT detection rates of lung cancer. We also used 130 HIV-infected patients with known lung cancer to determine radiographic markers of lung cancer risk using multivariate analysis.
resultsMedian age was 48 years with 34 pack-years smoked. During 678 person-years, one lung cancer was found on incident screening. Besides this lung cancer case, 18 deaths (8%) occurred, but none were cancer related. There were no interim diagnoses of lung or extrapulmonary cancers. None of the pulmonary nodules detected in 48 participants at baseline were diagnosed as cancer by study end. The heterogeneity of emphysema across the entire lung as measured by CT densitometry was significantly higher in HIV-infected subjects with lung cancer compared with the heterogeneity of emphysema in those without HIV (p ≤ 0.01). On multivariate regression analysis, increased age, higher smoking pack-years, low CD4 nadir, and increased heterogeneity of emphysema on quantitative CT imaging were all significantly associated with lung cancer.
conclusionsDespite a high rate of active smoking among HIV-infected participants, only one lung cancer was detected in 678 patient-years. This was probably because of the young age of participants suggesting that CT screening of high-risk populations should strongly consider advanced age as a critical inclusion criterion. Future screening trials in urban American must also incorporate robust measures to ensure HIV patient compliance, adherence, and smoking cessation.
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