Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
High Cancer Burden Among Antiretroviral Therapy Users in Malawi: A Record Linkage Study of Observational Human Immunodeficiency Virus Cohorts and Cancer Registry Data.
Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 18 citations in OpenAlex.
- End-user perspectives on design and implementation of a novel SkinScan3D (SS3D) device for monitoring Kaposi Sarcoma in East Africa: a qualitative study.medRxiv : the preprint server for health sciences · 2026Article
- Kaposi sarcoma in the era of immunodeficiency: challenges and opportunities for treatment and prevention.Annals of medicine and surgery (2012) · 2026Article
- Paracrine signals from HIV-1-infected immune cells reprogram cervical cancer pathways.iScience · 2026Article
- The Changing Face of HIV-Associated Malignancies: Is this the Same in Turkey As Well?Current HIV research · 2026Article
- Lymphoma in Sub-Saharan Africa: a scoping review of the epidemiology, treatment challenges, and patient pathways.Cancer causes & control : CCC · 2025Article
- State of the science and future directions for research on HIV and cancer: Summary of a joint workshop sponsored by IARC and NCI.International journal of cancer · 2024Review
- Gynaecologic and breast cancers in women living with HIV in South Africa: A record linkage study.International journal of cancer · 2024Article
- Incident Kaposi sarcoma during the expansion of antiretroviral therapy eligibility in Nigeria: a retrospective cohort study.BMC cancer · 2023Article
- Cancer incidence among people living with HIV in Zimbabwe: A record linkage study.Cancer reports (Hoboken, N.J.) · 2022Article
- Age-specific burden of cervical cancer associated with HIV: A global analysis with a focus on sub-Saharan Africa.International journal of cancer · 2022Article
- Mapping Evidence on the Burden of Breast, Cervical, and Prostate Cancers in Sub-Saharan Africa: A Scoping Review.Frontiers in public health · 2022Article
- Changes in HIV-Related Cervical Cancer Over a Decade in Côte d'Ivoire.JCO global oncology · 2021Article
- Antiretroviral therapy and Kaposi's sarcoma trends and outcomes among adults with HIV in Latin America.Journal of the International AIDS Society · 2021Observational
- Epidemiology of haematological malignancies in people living with HIV.The lancet. HIV · 2020Review
- International epidemiology databases to evaluate AIDS (IeDEA) in sub-Saharan Africa, 2012-2019.BMJ open · 2020Article
- High prevalence of non-communicable diseases among key populations enrolled at a large HIV prevention & treatment program in Kenya.PloS one · 2020Article
Corrections and comments
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Authors and funding
15 authors at 7 institutions in 3 countries.
Funding
Abstract
backgroundWith antiretroviral therapy (ART), AIDS-defining cancer incidence has declined and non-AIDS-defining cancers (NADCs) are now more frequent among human immunodeficiency virus (HIV)-infected populations in high-income countries. In sub-Saharan Africa, limited epidemiological data describe cancer burden among ART users.
methodsWe used probabilistic algorithms to link cases from the population-based cancer registry with electronic medical records supporting ART delivery in Malawi's 2 largest HIV cohorts from 2000-2010. Age-adjusted cancer incidence rates (IRs) and 95% confidence intervals were estimated by cancer site, early vs late incidence periods (4-24 and >24 months after ART start), and World Health Organization (WHO) stage among naive ART initiators enrolled for at least 90 days.
resultsWe identified 4346 cancers among 28 576 persons. Most people initiated ART at advanced WHO stages 3 or 4 (60%); 12% of patients had prevalent malignancies at ART initiation, which were predominantly AIDS-defining eligibility criteria for initiating ART. Kaposi sarcoma (KS) had the highest IR (634.7 per 100 000 person-years) followed by cervical cancer (36.6). KS incidence was highest during the early period 4-24 months after ART initiation. NADCs accounted for 6% of new cancers.
conclusionsUnder historical ART guidelines, NADCs were observed at low rates and were eclipsed by high KS and cervical cancer burden. Cancer burden among Malawian ART users does not yet mirror that in high-income countries. Integrated cancer screening and management in HIV clinics, especially for KS and cervical cancer, remain important priorities in the current Malawi context.
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