ASPO Abstracts
Racial/Ethnic Disparities in Cancer Outcomes among People with HIV in the United States: A Systematic Review
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
Purpose: People with HIV (PwH) are at heightened risk for cancer. It is unclear whether racial/ethnic disparities in cancer outcomes among PwH mirror the general population. In this systematic review, we critically reviewed and summarized racial/ethnic disparities in cancer outcomes among PwH by cancer type.Methods: A literature search was conducted through PubMed, Web of Science, Cochrane Library, ProQuest Thesis and Dissertations, and EMBASE using MeSH terms for race/ethnicity, cancer, and HIV and limited to studies published between 01/01/1980 and 06/23/2020 in English. Title/abstract, full-text screens, and data extraction were conducted by paired reviewers. Disagreements were resolved by discussion.Results: Of the 23 eligible studies, 12 (52%), 4 (17%), 5 (22%), and 5 (22%) studies assessed cancer risk, screening, treatment, and mortality among PwH, respectively. Studies on risk assessed human papilloma virus (HPV)-related, Kaposi sarcoma (KS), urogenital, and lung cancers. Compared to White men who have sex with men (MSM), KS risk appeared higher among Black MSM but lower for studies including only MSM with HHV-8 seropositivity. Prostate cancer risk was generally higher among Blacks vs Whites. Studies on screening covered cervical, breast, and colorectal cancers. Disparities in screening were not evident. Studies on treatment covered lymphoma and multiple cancers combined. Blacks were consistently less likely than Whites to receive treatment. Studies on mortality were limited to KS and HPV-related cancers. In general, Blacks had higher KS mortality compared to Whites. Overall, studies were rated poor to fair using the NIH Study Quality Assessment Tools with no study rated good.Conclusions: Given the wide range of diagnosable groups of cancers, studies investigating racial/ethnic disparities among PwH are extremely limited. The quality of current evidence is also poor. Thus, research with more rigor is warranted to address the gap in knowledge and target interventions to PwH for cancers and outcomes with conclusive evidence of racial/ethnic disparities.
Keywords: Racial/ethnic disparities; cancer; HIV