Primary lung cancer diagnoses in people living with HIV in a large clinical centre in Montreal, Canada over 3 decades

ABSTRACT

Lung cancer is the most frequent type of cancer-related death in people living with HIV (PLWH). We conducted a review of primary lung cancers in PLWH at the McGill University Health Centre from 1988–May 2018 to understand potential factors contributing to their development prior to the implementation of a lung cancer screening program. Twenty-seven individuals had a diagnosis of a lung tumor. Of these individuals, 21 (78%) had a primary lung cancer, over 21,428 person-years follow-up. Median age was 54.5 years [25th and 75th percentiles 49.0, 62.0]. Median CD4 count was 185.0 cells/μL [25th and 75th percentiles 54.0, 446.0] and 52% were on antitretroviral therapy with suppressed viral loads. Type of primary lung cancer included: non-small cell lung cancer (n = 15), small-cell lung cancer (n = 4) and bronchial carcinomas (n = 2). Metastatic disease at diagnosis was present in 11 (52%) persons. Survival was a median of 7.5 months from the time of diagnosis [25th and 75th percentiles 2.0, 9.0]. In conclusion, we observed a high proportion of lung cancers detected at very late stages of disease and with metastatic involvement. The implementation of a lung cancer screening program in 2018 should set a stage shift for earlier diagnosis and treatment.

KEYWORDS:

• Lung cancer
• lung cancer screening
• HIV
• co-morbidity
• clinical improvement

Acknowledgements

We wish to acknowledge Mr Costas Pexos for assistance with database quering.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

No funding was received to perform this study. C. Costiniuk and N. Ezer hold FRQ-S Junior 1 salary awards. JP. Routy holds the McGill University Louis Lowenstein Chair in Hematology & Oncology. The funding institutions played no role in the design, collection, analysis, and interpretation of data.