{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T01:40:31Z","timestamp":1775266831733,"version":"3.50.1"},"reference-count":58,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: With a high human immunodeficiency virus (HIV) adult prevalence, people living with HIV (PLHIV) in Botswana continue to experience a high burden of comorbid HIV and cancer. We sought to investigate the trends of acquired immunodeficiency syndrome (AIDS) defining cancers (ADCs), non-AIDS defining cancers (NADCs), and associated risk factors in PLHIV compared with those without HIV. Methods: We analyzed data from adults aged \u226518 years reported in Botswana National Cancer Registry and National Data Warehouse. The crude, age-standardized incidence rate (ASIR), standardized incidence ratios (SIRs) of cancers and time trends were computed. Risk factors were determined using the Cox-regression model. Results: Over a 30-year period, 27,726 cases of cancer were documented. Of these, 13,737 (49.5%) were PLHIV and 3505 (12.6%) were people without HIV and 10,484 (37.8%) had an unknown HIV status. Compared to the HIV-uninfected, the PLHIV had higher and increasing trends in the cancer incidence overall during the study period (from 44.2 to 1047.6 per 100,000; p-trend &lt; 0.001) versus (from 1.4 to 27.2 per 100,000; p-trend &lt; 0.001). The ASIRs also increased in PLHIV for overall ADCs, NADCs and other sub-types like cervical, lung, breast, and conjunctiva cancers (p-trend &lt; 0.001). Further, PLHIV had elevated SIRs for cervical cancer, Kaposi sarcoma in males and some NADCs. The most common risk factors were HIV infection and female sex for ADCs incidence and advanced age and being HIV-uninfected for NADCs incidence. Conclusions: Increasing trends of ADCs and NADCs during ART expansion were observed among PLHIV compared to those without HIV highlighting a greater need for targeted effective prevention and screening strategies including the provision of access to timely HIV and cancer treatment.<\/jats:p>","DOI":"10.3390\/cancers17142374","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T10:33:47Z","timestamp":1752748427000},"page":"2374","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Trends in Cancer Incidence and Associated Risk Factors in People Living with and Without HIV in Botswana: A Population-Based Cancer Registry Data Analysis from 1990 to 2021"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2464-843X","authenticated-orcid":false,"given":"Anikie","family":"Mathoma","sequence":"first","affiliation":[{"name":"College of Health Sciences, University of KwaZulu Natal, Durban Private Bag X54001 4000, South Africa"},{"name":"Division of Research and Enterprise, University of Botswana, Gaborone Private Bag 0022, Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gontse","family":"Tshisimogo","sequence":"additional","affiliation":[{"name":"Ministry of Health, Gaborone Private Bag 0038, Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benn","family":"Sartorius","sequence":"additional","affiliation":[{"name":"College of Health Sciences, University of KwaZulu Natal, Durban Private Bag X54001 4000, South Africa"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, QLD 4072, Australia"},{"name":"Centre for Tropical Medicine and Global Health, University of Oxford, Oxford OX1 2JD, UK"},{"name":"Department of Health Metric Sciences, University of Washington, Seattle, WA 98195, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saajida","family":"Mahomed","sequence":"additional","affiliation":[{"name":"College of Health Sciences, University of KwaZulu Natal, Durban Private Bag X54001 4000, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization Health Topics: HIV\/AIDS. 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