AIDS-related cancers in Africa: maturation of the epidemic in Uganda.

TLDR: The AIDS epidemic has dramatically changed the profile of cancer in Uganda, and trends in the AIDS-related cancers are consistent with current knowledge concerning the mechanisms behind the increased risk.

Abstract: The AIDS epidemic has passed its peak in Uganda with possible consequences for the risk of cancers related to infectious agents. The objective was to compare the incidence of cancers possibly linked to infections with HIV before the AIDS epidemic (the 1960s) at its high point (the early 1990s) when HIV- seroprevalence and AIDS notifications peaked and after the onset of its decline in the later 1990s. Analysis of incidence rates of infection-associated cancers in the population of Kyadondo county in 1960-71 1991-94 and 1995-97. Comparison with data on prevalence of HIV infection and notifications of AIDS. The incidence of Kaposis sarcoma has increased enormously since the 1960s with a shift to earlier age at onset and more generalized and nodal disease; there has been little change in the profile during the 1990s. There was a large increase in incidence of squamous cell carcinomas of the conjunctiva which has continued through the 1990s. Non-Hodgkins lymphomas showed little increase in incidence until the most recent period in which the incidence has increased both in children (particularly Burkitts lymphomas) and adults. Although the incidence of cervical cancer was higher in the 1990s than the 1960s it seems doubtful that this is related to HIV infection. Certain other cancers which have been linked to AIDS in western populations (Hodgkins disease anal carcinoma childhood leiomyosarcoma) show no changes in risk. The AIDS epidemic has dramatically changed the profile of cancer in Uganda. Trends in the AIDS-related cancers are consistent with current knowledge concerning the mechanisms behind the increased risk. The incidence of certain cancers with a viral etiology (liver cervix penis Hodgkins disease) appears not to have been influenced by AIDS. (authors)