Reduced Risk of Prostate Cancer in U.S. Men with AIDS

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Abstract
Background: Previous studies describe decreased prostate cancer risk in HIV-infected men. In the United States, prostate-specific antigen (PSA) screening is common and increases the detection of prostate cancer. We evaluated whether the prostate cancer deficit among men with AIDS reflects differential PSA screening. Methods: Data from the U.S. HIV/AIDS Cancer Match Study were used to calculate standardized incidence ratios (SIR) for prostate cancer, comparing men with AIDS (N = 287,247) to the general population. Furthermore, we estimated PSA testing rates in the Johns Hopkins HIV Clinical Cohort. Results: Prostate cancer rates increased over time in the general population and, beginning in the 1990s, were consistently higher than among men with AIDS. Men with AIDS had the same prostate cancer risk as the general population in the pre-PSA era (Conclusion: Prostate cancer risk was decreased by 50% among men with AIDS compared with the general population. This deficit was limited to the PSA era and early stage cancers. Impact: Our findings suggest that the prostate cancer deficit in HIV-infected men is largely due to differential PSA screening. Cancer Epidemiol Biomarkers Prev; 19(11); 2910–5. ©2010 AACR.