{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:45:11Z","timestamp":1787021111530,"version":"build-2736575974"},"reference-count":37,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Few data describe the modern epidemiology of pediatric HIV-associated cancers in sub-Saharan Africa, home to over 80% of the world's children living with HIV. This study evaluated the incidence of cancers among these children over 15 years after widespread antiretroviral therapy (ART) adoption in Malawi.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a retrospective population-based cohort study leveraging multiple independent data sources comprehensive of all cancer diagnoses among children living with HIV in Northern and Central Malawi between 2010 and 2024. HIV-associated cancers were defined as those cancers with well-established epidemiologic associations with HIV. Cumulative incidence and average annual percent change were estimated using joinpoint regression. Next, we conducted a subcohort analysis within the country's largest pediatric HIV clinic to evaluate cancer risk factors using log-binomial regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Among 1,686 pediatric cancer diagnoses, 184 (10.9%) occurred in children with HIV. Kaposi sarcoma (KS) accounted for 96% of cases. The cumulative incidence of HIV-associated malignancies fell from 4.7 cases per million children in 2010 to 1.2 per million in 2024, representing an 84% decline from its peak in 2013 and an average annual percent decline of 13% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). KS dropped from the third- to seventh-most common childhood cancer in the region. Notably, 58% of affected children were ART-na\u00efve at diagnosis. Initiating ART in infancy reduced the risk of KS by 69% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Other HIV-associated cancers were rare, comprising 0.4% of all cases diagnosed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>National ART expansion substantially reduced pediatric HIV-associated cancers in Malawi, achieving declines comparable with those seen in high-income countries. Sustained early diagnosis and ART linkage remain essential to sustain progress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-25-00448","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:59:11Z","timestamp":1772830751000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":1,"title":["Incidence of Cancers Among Children Living With HIV in Malawi After Widespread Availability of Antiretroviral Therapy: A Population-Based Study"],"prefix":"10.1200","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3968-4668","authenticated-orcid":true,"given":"Casey L.","family":"McAtee","sequence":"first","affiliation":[{"name":"Baylor College of Medicine, Houston, TX"},{"name":"Texas Children's Global HOPE, Houston, TX"},{"name":"Malawi National Cancer Centre, Lilongwe, 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