High Lung Cancer Rates in AIDS Not Entirely Due to Smoking

Lung cancer is the most prevalent non–AIDS-defining cancer among HIV-infected people, with rates substantially higher than in the uninfected population. How much of this excess risk is due to tobacco use, how much to immunosuppression, and how much to statistical confounders (such as over-ascertainment bias)?

Researchers linked cancer registry data with 1990–2002 AIDS-surveillance data for six states and five large U.S. metropolitan areas. During the 10-year period spanning 5 years before and 5 years after an AIDS diagnosis, overall lung cancer risk was almost four times higher in AIDS patients than in the general population. To minimize over-ascertainment bias in stratified analyses, researchers excluded the first 3 months after AIDS diagno…