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In sub-Saharan Africa, limited epidemiological data describe cancer burden among ART users.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used probabilistic algorithms to link cases from the population-based cancer registry with electronic medical records supporting ART delivery in Malawi\u2019s 2 largest HIV cohorts from 2000\u20132010. Age-adjusted cancer incidence rates (IRs) and 95% confidence intervals were estimated by cancer site, early vs late incidence periods (4\u201324 and &gt;24 months after ART start), and World Health Organization (WHO) stage among naive ART initiators enrolled for at least 90 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 4346 cancers among 28\u2009576 persons. Most people initiated ART at advanced WHO stages 3 or 4 (60%); 12% of patients had prevalent malignancies at ART initiation, which were predominantly AIDS-defining eligibility criteria for initiating ART. Kaposi sarcoma (KS) had the highest IR (634.7 per 100\u2009000 person-years) followed by cervical cancer (36.6). KS incidence was highest during the early period 4\u201324 months after ART initiation. NADCs accounted for 6% of new cancers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Under historical ART guidelines, NADCs were observed at low rates and were eclipsed by high KS and cervical cancer burden. Cancer burden among Malawian ART users does not yet mirror that in high-income countries. Integrated cancer screening and management in HIV clinics, especially for KS and cervical cancer, remain important priorities in the current Malawi context.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciy960","type":"journal-article","created":{"date-parts":[[2018,11,13]],"date-time":"2018-11-13T23:13:51Z","timestamp":1542150831000},"page":"829-835","source":"Crossref","is-referenced-by-count":20,"title":["High Cancer Burden Among Antiretroviral Therapy Users in Malawi: A Record Linkage Study of Observational Human Immunodeficiency Virus Cohorts and Cancer Registry Data"],"prefix":"10.1093","volume":"69","author":[{"given":"Marie-Jos\u00e8phe","family":"Horner","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill"},{"name":"University of North Carolina Project-Malawi, Lilongwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steady","family":"Chasimpha","sequence":"additional","affiliation":[{"name":"Malawi Cancer Registry, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Spoerri","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Bohlius","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannock","family":"Tweya","sequence":"additional","affiliation":[{"name":"Lighthouse Trust, Kamuzu Central Hospital, Lilongwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petros","family":"Tembo","sequence":"additional","affiliation":[{"name":"Lighthouse Trust, Kamuzu Central Hospital, Lilongwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franklin","family":"Nkhambule","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Central Hospital HIV Clinic, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eddie Moffo","family":"Phiri","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Central Hospital HIV Clinic, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health, Ohio State University, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kennedy","family":"Malisita","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Central Hospital HIV Clinic, Blantyre, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Phiri","sequence":"additional","affiliation":[{"name":"Lighthouse Trust, Kamuzu Central Hospital, Lilongwe"},{"name":"Department of Public Medicine, University of Malawi, Blantyre"},{"name":"Department of Medicine, University of North Carolina at Chapel Hill, Blantyre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Dzamalala","sequence":"additional","affiliation":[{"name":"Malawi Cancer Registry, Blantyre, Malawi"},{"name":"University of Malawi College of Medicine, Blantyre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew F","family":"Olshan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill"},{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill Lilongwe, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish","family":"Gopal","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill"},{"name":"University of North Carolina Project-Malawi, Lilongwe"},{"name":"University of Malawi College of Medicine, Blantyre"},{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill Lilongwe, Malawi"},{"name":"University of North Carolina Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill Lilongwe, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,11,17]]},"reference":[{"key":"2019100203115244600_CIT0001","unstructured":"UNAIDS. 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Malawi AIDS Response Progress Report. April 2015. Accessible at: http:\/\/www.unaids.org\/sites\/default\/files\/country\/documents\/MWI_narrative_report_2015.pdf [Accessed on 31 October 2015]."},{"key":"2019100203115244600_CIT0008","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1750-9378-9-1","article-title":"Cancer burden among HIV-positive persons in Nigeria: preliminary findings from the Nigerian AIDS-Cancer Match study","volume":"9","author":"Akarolo-Anthony","year":"2014","journal-title":"Infect Agent Cancer"},{"key":"2019100203115244600_CIT0009","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1002\/ijc.30154","article-title":"Record linkage to correct under-ascertainment of cancers in HIV cohorts: the Sinikithemba HIV Clinic Linkage project","volume":"139","author":"Sengayi","year":"2016","journal-title":"Int J Cancer"},{"key":"2019100203115244600_CIT0010","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1002\/ijc.21443","article-title":"Spectrum of cancers among HIV-infected persons in Africa: the Uganda AIDS-Cancer Registry Match study","volume":"118","author":"Mbulaiteye","year":"2006","journal-title":"Int J Cancer"},{"key":"2019100203115244600_CIT0011","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1111\/j.1365-3156.2010.02509.x","article-title":"Early active follow-up of patients on antiretroviral therapy (ART) who are lost to follow-up: the \u201cBack-to-Care\u201d project in Lilongwe, Malawi","volume":"15 Suppl 1","author":"Tweya","year":"2010","journal-title":"Trop Med Int Health"},{"key":"2019100203115244600_CIT0012","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1186\/1471-2458-13-490","article-title":"Evidence of improving antiretroviral therapy treatment delays: an analysis of eight years of programmatic outcomes in Blantyre, Malawi","volume":"13","author":"Sloan","year":"2013","journal-title":"BMC Public Health"},{"key":"2019100203115244600_CIT0013","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1186\/1756-0500-5-149","article-title":"Burden of cancer in Malawi; common types, incidence and trends: national population-based cancer registry","volume":"5","author":"Msyamboza","year":"2012","journal-title":"BMC Res Notes"},{"key":"2019100203115244600_CIT0014","doi-asserted-by":"crossref","first-page":"e70361","DOI":"10.1371\/journal.pone.0070361","article-title":"Early experience after developing a pathology laboratory in Malawi, with emphasis on cancer diagnoses","volume":"8","author":"Gopal","year":"2013","journal-title":"PLoS One"},{"key":"2019100203115244600_CIT0015","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1002\/ijc.28063","article-title":"Trends in the incidence of cancer in the black population of Harare, Zimbabwe 1991\u20132010","volume":"133","author":"Chokunonga","year":"2013","journal-title":"Int J Cancer"},{"key":"2019100203115244600_CIT0016","doi-asserted-by":"crossref","first-page":"e271","DOI":"10.1016\/j.canep.2012.04.007","article-title":"Cancer incidence in Nigeria: a report from population-based cancer registries","volume":"36","author":"Jedy-Agba","year":"2012","journal-title":"Cancer Epidemiol"},{"key":"2019100203115244600_CIT0017","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1002\/ijc.23487","article-title":"Cancer risk in people infected with human immunodeficiency virus in the United States","volume":"123","author":"Engels","year":"2008","journal-title":"Int J Cancer"},{"key":"2019100203115244600_CIT0018","volume-title":"International Classification of Diseases for Oncology, 2nd edition (ICD-O-2)","author":"Percy","year":"1990"},{"key":"2019100203115244600_CIT0019","unstructured":"National Statistical Office of Malawi (NSO). 2008 Population and Housing Census. 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