{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:02:42Z","timestamp":1793721762344,"version":"4.6.1"},"reference-count":31,"publisher":"Wiley","issue":"16","license":[{"start":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T00:00:00Z","timestamp":1556841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2019,8,15]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People living with HIV (PLWH) are at an increased risk of developing several cancers, but to the authors\u2019 knowledge less is known regarding how HIV impacts the rate of progression to advanced cancer or death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors compared stage of disease at the time of presentation and mortality after diagnosis between 14,453 PLWH and 6,368,126 HIV\u2010uninfected patients diagnosed with cancers of the oral cavity, stomach, colorectum, anus, liver, pancreas, lung, female breast, cervix, prostate, bladder, kidney, and thyroid and melanoma using data from the National Cancer Data Base (2004\u20102014). Polytomous logistic regression and Cox proportional hazards regression were used to evaluate the association between HIV, cancer stage, and stage\u2010adjusted mortality after diagnosis, respectively. Regression models accounted for the type of health facility at which cancer treatment was administered and the type of individual health insurance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      HIV\u2010infected patients with cancer were found to be more likely to be uninsured (HIV\u2010infected: 5.0% vs HIV\u2010uninfected: 3.3%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.0001) and were less likely to have private health insurance (25.4% vs 44.7%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.0001). Compared with those not infected with HIV, the odds of being diagnosed at an advanced stage of disease were significantly elevated in PLWH for melanoma and cancers of the oral cavity, liver, female breast, prostate, and thyroid (odds ratio for stage IV vs stage I range, 1.24\u20102.06). PLWH who were diagnosed with stage I to stage III disease experienced elevated mortality after diagnosis across 13 of the 14 cancer sites evaluated, with hazard ratios ranging from 1.20 (95% CI, 1.14\u20101.26) for lung cancer to 1.85 (95% CI, 1.68\u20102.04), 1.85 (95% CI, 1.51\u20102.27), and 2.93 (95% CI, 2.08\u20104.13), respectively, for cancers of the female breast, cervix, and thyroid.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PLWH were more likely to be diagnosed with advanced\u2010stage cancers and to experience elevated mortality after a cancer diagnosis, even after accounting for health care\u2013related factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.32158","type":"journal-article","created":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T08:49:38Z","timestamp":1556873378000},"page":"2868-2876","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":121,"title":["Advanced stage at diagnosis and elevated mortality among US patients with cancer infected with HIV in the National Cancer Data Base"],"prefix":"10.1002","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7142-7499","authenticated-orcid":false,"given":"Anna E.","family":"Coghill","sequence":"first","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda Maryland"},{"name":"Cancer Epidemiology Program H. Lee Moffitt Cancer Center and Research Institute Tampa Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuesong","family":"Han","sequence":"additional","affiliation":[{"name":"Surveillance and Health Services Research American Cancer Society Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gita","family":"Suneja","sequence":"additional","affiliation":[{"name":"Radiation Oncology Duke University Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun Chieh","family":"Lin","sequence":"additional","affiliation":[{"name":"Surveillance and Health Services Research American Cancer Society Atlanta Georgia"},{"name":"Health Services Research Program University of Michigan Ann Arbor Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0000-4111","authenticated-orcid":false,"given":"Ahmedin","family":"Jemal","sequence":"additional","affiliation":[{"name":"Surveillance and Health Services Research American Cancer Society Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8390-6091","authenticated-orcid":false,"given":"Meredith S.","family":"Shiels","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.13.1736"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181b033ab"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djp205"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/605594"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-11-0777"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61050-2"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(17)30125-X"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.23487"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt153"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000238411.75324.59"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/94.16.1204"},{"issue":"1","key":"e_1_2_8_13_1","first-page":"S34","article-title":"Impact of potent antiretroviral therapy on the incidence of Kaposi's sarcoma and non\u2010Hodgkin's lymphomas among HIV\u20101\u2013infected individuals. 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