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Abstract
Highly active antiretroviral therapy (HAART) has significantly altered the epidemiology of cancer that is diagnosed in individuals who are infected with the human immunodeficiency virus (HIV). Studies have shown a dramatic decrease in the incidence of and mortality from AIDS-related malignancies (primarily Kaposi sarcoma and non-Hodgkin's lymphoma), while the incidence of and mortality from non-AIDS defining malignancies is on the rise. While the risk of colorectal cancer (CRC) in HIV-infected individuals is controversial and has received limited study, there has been accumulating evidence that suggests an increased risk of developing anal cancer (AC) during the HAART era. This article reviews the current literature reporting on CRC and AC in the HIV-infected population, with a specific on cancer: incidence, screening, clinical characteristics, and treatment outcomes.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.
No writing assistance was utilized in the production of this manuscript.
Key issues
Colorectal cancer (CRC) is the fourth most commonly diagnosed cancer type in men and women in the USA and Canada, while anal cancer (AC) is uncommon in the general population.
Highly active antiretroviral therapy has dramatically altered the incidence, morbidity, mortality and types of cancers that develop in HIV-positive patients.
A literature review focused on CRC in HIV-positive patients has not shown a significant difference in its incidence when compared with the general population.
CRC screening rates in HIV-positive patients are significantly lower when compared with the general population.
The incidence of AC in HIV-positive patients during the highly active antiretroviral therapy period has significantly increased.
Clear and standardized AC screening guidelines need to be developed for HIV-positive patients.
Future studies are needed to evaluate pathophysiology, screening, diagnosis, treatment and role of vaccine prevention strategies, for AC in HIV patients.