HIV-Positive Patients Less Likely to Receive Cancer Treatment

Patients with both HIV and cancer are less likely to receive treatment for common cancers, regardless of insurance status.

Findings from a new study suggest that HIV-positive patients diagnosed with cancer are less likely to receive cancer treatment, regardless of insurance status or other factors.

Researchers in the study, published in Cancer, analyzed data from the National Cancer Data Base, including non-elderly adults with 10 common cancers from 2003 to 2011.

The 2 known predictors for lack of treatment were adjusted by researchers. Factors that predicted lack of cancer treatment among HIV-positive patients were black race and a lack of private insurance (having Medicaid, Medicare or no insurance), both found to be predictors for patients with varying tumor types.

The results showed HIV-positive patients were more likely to lack treatment for cancers of the head and neck (relative risk [RR] = 1.48), upper gastrointestinal tract (RR = 2.62), colorectal (RR = 1.70), lung (RR = 2.46), breast (RR = 2.14), cervix (RR = 2.81), prostate (RR = 2.16), Hodgkin lymphoma (RR = 1.92), and diffuse large B-cell lymphoma (RR = 1.82), according to the study.

Among privately insured patients, researchers noted that HIV-infected cancer patients are less likely to receive cancer treatment compared with HIV-uninfected patients.

According to the study, these findings are attributable to several factors. Since HIV-positive patients are typically not included in cancer clinical trials, there is a lack of data for this population and cancer treatment guidelines for these patients are typically unavailable.

Clinicians may be inexperienced in treating these patients. There are also psychosocial and economic challenges associated with HIV and cancer that could challenge adherence.

"Cancer care providers and policy makers need to devote special attention to the HIV-infected patient population to understand and address the factors driving differential cancer treatment," the authors concluded. "Cancer treatment not only extends survival from cancer, but also can improve quality of life, even for patients with advanced stage disease. The observed disparity is of particular importance given the extended survival of HIV infected patients treated with antiretroviral therapy and the rising number of cancer cases."