ArticleJournal of the National Cancer Institute2026
Sex differences in cancer incidence among people with HIV infection in the United States.
Article in Journal of the National Cancer Institute, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveMales have a higher incidence of most non-reproductive cancers than females, which has often been attributed to differences in lifestyle or behaviors. We examined whether sex differences in cancer incidence are attenuated among immunocompromised adults.
methodsUsing data from population-based linkage study of HIV and cancer registries (2001-2019), we estimated male-to-female incidence rate ratios (M:F IRRs) among people with HIV (PWH) for 20 cancer sites. We used Poisson regression to adjust for age, race/ethnicity, calendar year, HIV transmission category, and HIV diagnosis year. We compared the M:F IRRs among PWH (M:F IRRPWH) to M:F IRRs in the general population (M:F IRRGP) with a chi-square test.
resultsPWH contributed 3,956,838 person-years of follow-up (53.6% among males, 46.4% among females). The M:F IRRPWH was significantly attenuated compared to the M:F IRRGP for 9 cancer sites: tongue (M:F IRRPWH 1.39 vs. M:F IRRGP 2.94; P<0.0001), oropharynx (1.80 vs 4.74; P<0.0001), esophagus (1.36 vs 3.43; P<0.0001), colon (0.90 vs 1.19; P=0.0002), liver (2.20 vs 4.22; P < 0.0001), larynx (1.50 vs 4.32; P<0.0001), lung (0.92 vs 1.39; P < 0.0001), bladder (1.21 vs 3.02; P<0.0001), and diffuse large B-cell lymphoma (1.35 vs 1.65; P<0.0001). Hodgkin lymphoma was the only site where the M:F IRRPWH was significantly larger than the M:F IRRGP (1.96 vs 1.45; P=0.0001).
conclusionsAlthough the incidence of most cancers remained higher among male than female PWH, the sex difference was attenuated among PWH for 9 cancers, suggesting that important immune differences between males and females in the general population contribute to differences in cancer incidence.
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