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Women
with AIDS Have Reduced Risk of Developing Breast and Uterine Cancer
By Megan Rauscher
Women
with AIDS have a lower risk of developing cancer of the breast
and uterine corpus (endometrial), perhaps because of alterations
in body fat and hormone imbalance, a researcher from the National
Cancer Institute told participants at the 96th annual meeting of
the American Association for Cancer Research.
"Naively,
you'd think that all cancers would be increased in the setting of
AIDS," Dr. James J. Goedert noted in an interview with Reuters
Health. "In this study, we matched women with AIDS to several
million cancer records and looked for differences in the incidence
of cancer of the breast, ovarian, and uterine corpus."
Of
77,369 women with AIDS followed for 592,578 person-years from 5
years before to 10 years after diagnosis of AIDS, 274 developed
breast cancer, 31 developed ovarian cancer, and 29 developed cancer
of the uterine corpus.
The
incidence of breast cancer in both pre- and postmenopausal women
was reduced by 32% in women with AIDS, with a standardized incidence
ratio (SIR) of 0.68. Even after adjusting for childbearing, breast
cancer risk was reduced by roughly 27% in women with AIDS.
According
to Dr. Goedert, "the deficit in breast cancer among women with
AIDS was largest in the early years of the HIV epidemic, intermediate
in the early 1990s and in the HAART era is actually approaching
what you'd expect in the general population. We don't have a ready
explanation for this," he admitted, but the data do support
the hypothesis that breast cancer risk is associated with HIV treatment.
The
researchers also observed a 40% reduction in the incidence of uterine
corpus cancer among postmenopausal women with AIDS (SIR 0.60), while
ovarian cancer incidence was not markedly reduced or increased in
women with AIDS (SIR 0.85).
"A
biological explanation for the deficits in postmenopausal endometrial
cancer as well as breast cancer may be hypoestrogenemia and hypoandrogenemia
with AIDS and tied into that may be reduced body fat," Dr.
Goedert said.
"Particularly
in the postmenopausal era, body fat actually accounts for a lot
of the circulating estrogens, and women with AIDS relatively speaking
are skinnier and have a different body fat distribution than women
in the general population," he explained.
04/20/05
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