{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:06:56Z","timestamp":1782846416866,"version":"3.54.5"},"reference-count":38,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n People living with HIV are at increased risk for developing cancer, a leading cause of death in this population. The management of cancer in people living with HIV is particularly challenging, necessitating specialized, interdisciplinary care. However, insights into cancer care provision for people living with HIV in Germany remain scarce.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study analyzed inpatient cancer care for people living with HIV, comparing treatment patterns and complications with those of an HIV-negative control group. Using claims data from 3 German university hospitals related to admissions between 2005 and 2022, we aimed to identify care disparities and provide evidence to support improved cancer management.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A customized federated approach was used to analyze inpatient claims data of patients across the 3 data-holding institutions. The data included demographics, diagnoses, procedures, and treatment codes as well as discharge information. Using nearest-neighbor matching, we analyzed demographic features, cancer diagnoses, anticancer therapies, and outcomes in people living with HIV and cancer and for a control group of HIV-negative patients with cancer.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 162,380 patients, 907 (0.6%) were people living with HIV and cancer. The count of cancer diagnoses declined over time, particularly for AIDS-defining cancers (total cancer diagnoses:\n P<\/jats:italic>\n =.001; AIDS-defining cancers:\n P<\/jats:italic>\n =.002), with a shift toward older age at diagnosis. Compared with matched controls, people living with HIV and cancer had longer hospital stays, experienced more postchemotherapy complications (cancer with HIV: 64\/907, 15.6%; cancer without HIV: 20\/907, 5.5%;\n P<\/jats:italic>\n <.001), and showed higher rates of metastasis after initial diagnosis (cancer with HIV: 128\/267, 47.9%; cancer without HIV: 97\/287, 33.8%;\n P<\/jats:italic>\n <.001). People living with HIV and cancer also showed increased in-hospital mortality, although mortality declined over time (\n P<\/jats:italic>\n =.02). Our data suggested differences in documented therapy modalities between the compared groups, with people living with HIV and cancer receiving more chemo- and immunotherapy and less surgery.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Using federated analysis techniques, we were able to show that cancer diagnoses and mortality among people living with HIV in Germany have decreased over time; however, disparities in treatment and outcomes persisted as compared with HIV-negative patients with cancer. Our findings underscore the need for tailored, multidisciplinary care strategies to improve cancer management for this population.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/81092","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T19:20:08Z","timestamp":1765912808000},"page":"e81092-e81092","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Epidemiology of Cancer in People Living With HIV in Germany: Retrospective, Observational, Multicenter Federated Claims Data Analysis"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1088-0502","authenticated-orcid":false,"given":"Bastian","family":"Reiter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2374-5550","authenticated-orcid":false,"given":"Stefanie","family":"Andreas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7932-5884","authenticated-orcid":false,"given":"Linnea","family":"Schumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4947-4245","authenticated-orcid":false,"given":"Bernd","family":"Bender","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2575-0487","authenticated-orcid":false,"given":"Isabel","family":"Schnorr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4056-6625","authenticated-orcid":false,"given":"Andreas","family":"Heidenreich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3777-9006","authenticated-orcid":false,"given":"Christoph","family":"Stephan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1235-1740","authenticated-orcid":false,"given":"Andrea","family":"Prunotto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0641-3754","authenticated-orcid":false,"given":"Andrea","family":"Laukhuf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6514-4230","authenticated-orcid":false,"given":"Julius","family":"Wehrle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6952-8442","authenticated-orcid":false,"given":"Matthias","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9970-7058","authenticated-orcid":false,"given":"Fabio Paul","family":"Aubele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6998-5429","authenticated-orcid":false,"given":"Marlien","family":"Hagedorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0671-152X","authenticated-orcid":false,"given":"Fady","family":"Albashiti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9830-8350","authenticated-orcid":false,"given":"Ulrich","family":"Seybold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1347-2838","authenticated-orcid":false,"given":"Julia","family":"Roider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3460-1299","authenticated-orcid":false,"given":"Melanie","family":"Stecher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6266-8987","authenticated-orcid":false,"given":"Daniel","family":"Maier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5446-7170","authenticated-orcid":false,"given":"J\u00f6rg Janne","family":"Vehreschild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"R1","unstructured":"UNAIDS data 2024. Joint United Nations Programme on HIV\/AIDS; 2024. URL: https:\/\/www.unaids.org\/en\/resources\/documents\/2024\/2024_unaids_data [Accessed 24-01-2026]"},{"issue":"5","key":"R2","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1111\/j.1468-1293.2010.00879.x","article-title":"Cohort profile: the German ClinSurv HIV project--a multicentre open clinical cohort study supplementing national HIV surveillance","volume":"12","author":"B\u00e4tzing-Feigenbaum","journal-title":"HIV Med"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.tips.2021.10.004","article-title":"Update and latest advances in antiretroviral therapy","volume":"43","author":"Men\u00e9ndez-Arias","journal-title":"Trends Pharmacol Sci"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1404255","article-title":"Long-acting prescriptions and therapy for HIV-1 from market launch to the present in Germany (May 2021 to December 2023)","volume":"12","author":"Schmidt","journal-title":"Front Public Health"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1097\/01.qai.0000233310.90484.16","article-title":"Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study","volume":"43","author":"Palella","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"2","key":"R6","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1097\/01.qai.0000247229.68246.c5","article-title":"Risk of non-AIDS-related mortality may exceed risk of AIDS-related mortality among individuals enrolling into care with CD4+ counts greater than 200 cells\/mm3","volume":"44","author":"Lau","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","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","journal-title":"Int J Cancer"},{"issue":"5","key":"R8","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1097\/CCO.0b013e3282c8c90d","article-title":"AIDS-defining and non-AIDS-defining malignancies: cancer occurrence in the antiretroviral therapy era","volume":"19","author":"Silverberg","journal-title":"Curr Opin Oncol"},{"issue":"6","key":"R9","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1093\/jnci\/dji072","article-title":"Cancer risk in the Swiss HIV Cohort Study: associations with immunodeficiency, smoking, and highly active antiretroviral therapy","volume":"97","author":"Clifford","journal-title":"J Natl Cancer Inst"},{"issue":"3","key":"R10","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1186\/2047-783x-16-3-101","article-title":"Cancer risk in HIV-infected individuals on HAART is largely attributed to oncogenic infections and state of immunocompetence","volume":"16","author":"Vogel","journal-title":"Eur J Med Res"},{"issue":"RR-17","key":"R11","first-page":"1","volume":"41","journal-title":"MMWR Recomm Rep"},{"issue":"9581","key":"R12","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/S0140-6736(07)61050-2","article-title":"Incidence of cancers in people with HIV\/AIDS compared with immunosuppressed transplant recipients: a meta-analysis","volume":"370","author":"Grulich","journal-title":"Lancet"},{"issue":"5","key":"R13","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1097\/QAI.0b013e3181b327ca","article-title":"A meta-analysis of the incidence of non-AIDS cancers in HIV-infected individuals","volume":"52","author":"Shiels","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"12","key":"R14","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1097\/01.aids.0000238411.75324.59","article-title":"Trends in cancer risk among people with AIDS in the United States 1980-2002","volume":"20","author":"Engels","journal-title":"AIDS"},{"issue":"1","key":"R15","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1097\/QAD.0b013e328317cc2d","article-title":"Trends in the incidence of cancers among HIV-infected persons and the impact of antiretroviral therapy: a 20-year cohort study","volume":"23","author":"Crum-Cianflone","journal-title":"AIDS"},{"issue":"4","key":"R16","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1111\/hiv.12421","article-title":"Life expectancy of HIV-positive people after starting combination antiretroviral therapy: a meta-analysis","volume":"18","author":"Teeraananchai","journal-title":"HIV Med"},{"issue":"21","key":"R17","doi-asserted-by":"publisher","first-page":"20590","DOI":"10.1002\/cam4.6585","article-title":"Cancer screening in people living with HIV","volume":"12","author":"Masi\u00e1","journal-title":"Cancer Med"},{"issue":"1","key":"R18","doi-asserted-by":"publisher","DOI":"10.4084\/MJHID.2019.004","article-title":"HIV and lymphoma: from epidemiology to clinical management","volume":"11","author":"Re","journal-title":"Mediterr J Hematol Infect Dis"},{"issue":"4","key":"R19","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1097\/QAD.0000000000000071","article-title":"Malignancies in HIV\/AIDS: from epidemiology to therapeutic challenges","volume":"28","author":"Rubinstein","journal-title":"AIDS"},{"issue":"22","key":"R20","doi-asserted-by":"publisher","first-page":"2344","DOI":"10.1200\/JCO.2013.54.8644","article-title":"Cancer treatment disparities in HIV-infected individuals in the United States","volume":"32","author":"Suneja","journal-title":"J Clin Oncol"},{"issue":"16","key":"R21","doi-asserted-by":"publisher","first-page":"2868","DOI":"10.1002\/cncr.32158","article-title":"Advanced stage at diagnosis and elevated mortality among US patients with cancer infected with HIV in the National Cancer Data Base","volume":"125","author":"Coghill","journal-title":"Cancer"},{"issue":"S 01","key":"R22","doi-asserted-by":"publisher","first-page":"e82","DOI":"10.3414\/ME17-02-0025","article-title":"MIRACUM: Medical Informatics in Research and Care in University Medicine","volume":"57","author":"Prokosch","journal-title":"Methods Inf Med"},{"issue":"S 01","key":"R23","doi-asserted-by":"publisher","first-page":"e92","DOI":"10.3414\/ME18-02-0004","article-title":"Smart Medical Information Technology for Healthcare (SMITH)","volume":"57","author":"Winter","journal-title":"Methods Inf Med"},{"issue":"8","key":"R24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v042.i08","article-title":"MatchIt: nonparametric preprocessing for parametric causal inference","volume":"42","author":"Ho","journal-title":"J Stat Softw"},{"issue":"6","key":"R25","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1097\/MLR.0b013e31819432e5","article-title":"A modification of the Elixhauser comorbidity measures into a point system for hospital death using administrative data","volume":"47","author":"van Walraven","journal-title":"Med Care"},{"issue":"5","key":"R26","doi-asserted-by":"publisher","first-page":"1378","DOI":"10.1213\/ANE.0000000000005398","article-title":"Count data in medical research: Poisson regression and negative binomial regression","volume":"132","author":"Schober","journal-title":"Anesth Analg"},{"key":"R27","unstructured":"Hijmans RJ . Rspatial\/geosphere. GitHub. 2024. URL: https:\/\/github.com\/rspatial\/geosphere [Accessed 25-01-2026]"},{"key":"R28","unstructured":"R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing. 2024. URL: https:\/\/www.R-project.org [Accessed 25-01-2026]"},{"key":"R29","doi-asserted-by":"crossref","unstructured":"Venables WN Ripley BD . Modern Applied Statistics with S-PLUS. 4th ed. Springer; 2002. [doi: 10.1007\/978-0-387-21706-2]","DOI":"10.1007\/978-0-387-21706-2"},{"key":"R30","doi-asserted-by":"crossref","unstructured":"Pebesma EJ Bivand R . Spatial Data Science: With Applications in R. Chapman and Hall\/CRC; 2023. ISBN: 9781138311183","DOI":"10.1201\/9780429459016"},{"issue":"4","key":"R31","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1007\/s11904-015-0283-7","article-title":"Cancer in the HIV-infected host: epidemiology and pathogenesis in the antiretroviral era","volume":"12","author":"Brickman","journal-title":"Curr HIV\/AIDS Rep"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2016.10.004","article-title":"HIV and aging","volume":"53","author":"Wing","journal-title":"Int J Infect Dis"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101585","article-title":"Immunogenicity, safety, and efficacy of the HPV vaccines among people living with HIV: a systematic review and meta-analysis","volume":"52","author":"Staadegaard","journal-title":"EClinicalMedicine"},{"issue":"7_suppl6","key":"R34","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120S00412","article-title":"Rotator cuff repair in HIV-infected patients: an analysis of postoperative complications","volume":"8","author":"Gu","journal-title":"Orthop J Sports Med"},{"issue":"3","key":"R35","doi-asserted-by":"publisher","first-page":"557","DOI":"10.2190\/CY03-EV15-K38Y-X4AA","article-title":"Home or hospital? An evaluation of the costs, preferences, and outcomes of domiciliary chemotherapy","volume":"30","author":"King","journal-title":"Int J Health Serv"},{"issue":"6","key":"R36","doi-asserted-by":"publisher","first-page":"e380","DOI":"10.1200\/JOP.2014.001545","article-title":"Patients prefer chemotherapy on the same day as their medical oncology outpatient appointment","volume":"10","author":"Lau","journal-title":"J Oncol Pract"},{"issue":"4","key":"R37","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1111\/hiv.13601","article-title":"Areas with high HIV prevalence: a spatial analysis of nationwide claims data in Germany","volume":"25","author":"Akmatov","journal-title":"HIV Med"},{"issue":"6","key":"R38","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1093\/ije\/dyu188","article-title":"DataSHIELD: taking the analysis to the data, not the data to the analysis","volume":"43","author":"Gaye","journal-title":"Int J Epidemiol"}],"container-title":["JMIR Public Health and Surveillance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publichealth.jmir.org\/2026\/1\/e81092","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:14:47Z","timestamp":1782843287000},"score":1,"resource":{"primary":{"URL":"https:\/\/publichealth.jmir.org\/2026\/1\/e81092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,13]]},"references-count":38,"URL":"https:\/\/doi.org\/10.2196\/81092","relation":{},"ISSN":["2369-2960"],"issn-type":[{"value":"2369-2960","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,13]]},"article-number":"v12i5e81092"}}